Abstract
BackgroundRegional corticosteroid therapy for noninfectious uveitis is well-established but usage patterns have not been studied extensively. This study aims to assess practice patterns of retina and uveitis specialists regarding their preferences on the use of local corticosteroid therapy.MethodsA 13-question survey was developed regarding the practice patterns of regional corticosteroid use in specific situations and populations. The survey was distributed to both the American Uveitis Society and Macula Society.ResultsResponses from 87 ophthalmologists were analyzed. The two most commonly used drugs were the dexamethasone intravitreal implant (Ozurdex®) and posterior sub-tenon’s triamcinolone (also known as posterior sub-Tenon’s Kenalog, or PSTK). Regional corticosteroids were used more frequently as first-line treatment in more than half of posterior uveitis cases when compared to anterior uveitis (39.1–46.0% vs 10.3%, respectively). Respondents were more willing to use regional corticosteroids in more than half of unilateral uveitis cases than in bilateral cases (54.7% vs 18.6%, respectively). A majority of respondents (67.1%) stated that they would avoid using regional corticosteroids in patients under 8 years old.ConclusionsOur results demonstrate more frequent regional corticosteroid use in posterior segment uveitis, unilateral cases, and avoidance in younger pediatric patients. Overall, the variability in these responses highlights the need for guidelines regarding regional corticosteroid use.
Highlights
Regional corticosteroid therapy for noninfectious uveitis is well-established but usage patterns have not been studied extensively
There are few guidelines specifying how these therapies should be implemented in different clinical scenarios, giving rise to more variability. The goal of this survey was to assess contemporary practice patterns of retina and uveitis specialists regarding their use of regional corticosteroids as a way to better understand indications and variations in practice
The preference for posterior sub-tenon’s triamcinolone (PSTK) and Ozurdex compared to intravitreal triamcinolone acetonide (IVTA) may be due to the increased risk of intraocular hypertension with IVTA compared to PSTK [30, 31], this was not demonstrated in the POINT Trial [29]
Summary
Regional corticosteroid therapy for noninfectious uveitis is well-established but usage patterns have not been studied extensively. Uveitic diseases are caused by either infectious or noninfectious etiologies, with noninfectious cases comprising the majority of cases in developed countries [1, 5]. Anterior uveitis is the Corticosteroids are the standard of care treatment for noninfectious uveitis and can be administered topically, regionally, or systemically [7]. Regional delivery via corticosteroid injections was developed to maximize drug delivery to the ocular target tissue over a defined period of time and minimize systemic adverse effects that result from oral formulations [8, 9] Regional corticosteroids are commonly used in the treatment of noninfectious uveitis, including in cases of active intraocular inflammation and uveitic macular edema [10,11,12].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
