DEXAMETHASONE INTRAVITREAL IMPLANT FOR TREATMENT OF UVEITIC PERSISTENT CYSTOID MACULAR EDEMA IN VITRECTOMIZED PATIENTS

Abstract

To evaluate the safety and efficacy of Ozurdex (dexamethasone intravitreal implant) 0.7 mg in the treatment of uveitic macular edema in vitrectomized eyes. Data from 13 patients (17 eyes) with persistent uveitic cystoid macular edema and a history of pars plana vitrectomy in the study eyes that were treated with intravitreal injection of 0.7-mg dexamethasone implant were reviewed retrospectively. Main outcome measures were changes in central retinal thickness measured by optical coherence tomography and changes in best-corrected visual acuity. The median age of patients was 61 years (range, 19-81 years). The median duration of uveitic macular edema was 12 months (range, 2-72 months). The mean baseline central retinal thickness (95% confidence interval) was 461.6 μm (403.8-519.4), decreased to 277.2 μm (244.6-309.8) at 4 weeks (P < 0.01), remained low at 349.9 μm (281.8-418.0) at 3 months (P = 0.01), and then reached 394.1 μm (328.3-459.8) at 6 months (P = 0.14). After 3 months, there was a median improvement of 2 lines of best-corrected visual acuity, with 52.9% of eyes gaining 2 lines or more (P < 0.01). At 6 months, there were 5 eyes that maintained the 2 lines gain and none had lost >1 line from baseline (P = 0.03). In 8 eyes (47.1%), reinjection of the implant was performed at a mean of 6.5 months. Ocular hypertension (47.1%), hypotony (11.8%), anterior chamber displacement of the implant (5.9%), and glaucoma, which required filtration surgery (5.9%), were the most common adverse events. Mean follow-up was 9.6 months (range, 6-17 months). In this small case series of eyes with limited follow-up, treatment with dexamethasone intravitreal implant injection for uveitic macular edema in vitrectomized eyes was associated with favorable visual outcomes and had an acceptable safety profile.