The initial visual acuity (VA) prior to treatment initiation can significantly influence long-term visual outcomes. The current analysis aimed to examine change in VA by baseline vision categories and their effects on time spent within visual change categories in patients with diabetic macular oedema (DMO) who underwent treatment with the intravitreal fluocinolone acetonide (FAc) implant. This was a post-hoc analysis of the IRISS-Registry Data. Time-in-range (TIR) was calculated based on three VA letter-score-thresholds: ≥70, ≥65, and ≥60 ETDRS letters after treatment initiation. TIR was stratified by baseline VA in three groups: 0-33, 34-68, and 69-100 letters. The primary outcome was the mean TIR for the ≥70 letters threshold (equivalent to 6/12 in Snellen). A total of 671 eyes from 542 patients were included. VA improved significantly in all VA swimlane groups, with 84.8%, 71.7%, and 60.0% of eyes in the 0-33, 34-68, and 69-100 baseline VA categories, respectively, showing maintained or improved VA at 36 months (p = 0.0367). The mean TIR for the ≥70 letter threshold was significantly longer in the 69-100 letters subgroup (892.7 ± 413.4 days) compared to the 34-68 (648.4 ± 366.4 days) and 0-33 (251.3 ± 175.9 days) subgroups (p < 0.0001). No significant differences in TIR were observed based on the duration of DMO or the number of previous anti-angiogenic injections. Eyes with better initial VA maintained functionally better visual acuity for longer following FAc implant treatment. TIR emerged as a potentially clinically relevant endpoint for evaluating long-term treatment outcomes in DMO, offering a broader perspective than traditional VA measures.

To evaluate the real-world safety and efficacy of the 0.19 mg fluocinolone acetonide intravitreal implant for the management of diabetic macular edema (DME). This retrospective study included 94 eyes from 58 patients, of whom all but 1 had type 2 diabetes. The mean age (± SD) was 75.5 ± 2.12 years. Each patient received at least 1 fluocinolone acetonide implant after a corticosteroid trial without significant intraocular pressure elevation. Data were collected from visits up to 18 months preimplantation (mean, 14.6 months) and 3 years postimplantation (mean, 51 months). Key outcomes included central subfield thickness (CST), visual acuity (VA), intraocular pressure, retinal thickness variability measures, and treatment frequency. Mean baseline VA remained stable, decreasing from 61.5 ± 1.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters preimplantation to 58.2 ± 0.3 ETDRS letters postimplantation (P = .034). Mean CST decreased significantly from 427.6 ± 20.8 µm 1 month preimplantation to 310.6 ± 11.4 µm at final follow-up (P < .001). Annual treatment frequency dropped significantly from 4.6 ± 0.95 injections preimplantation to 2.3 ± 0.25 injections postimplantation (P = .021). Retinal thickness variability improved significantly (80.4 ± 5.8 µm to 63.8 ± 4.6 µm; P = .027), with a corresponding CST area under the curve (351.1 ± 13.5 µm² to 296.7 ± 10.9 µm²; P = .002). Intraocular pressure remained stable, increasing slightly from 15.8 mmHg to 16.3 mmHg. No new safety signals were observed. The fluocinolone acetonide implant demonstrated sustained visual stability, significant anatomical improvement, reduced treatment burden, and a manageable safety profile. These findings support its role as an effective long-term therapeutic option for DME, including in vitrectomized eyes.

Citrobacter koseri is a gram-negative bacillus primarily found in the gut. Exogenous endophthalmitis caused by C. koseri is exceedingly rare, with most reported cases occurring secondary to ocular trauma and resulting in poor visual outcomes. This report presents a case of a 76-year-old patient who developed endophthalmitis following a fluocinolone acetonide intravitreal injection administered for diabetic macular edema. A vitreous biopsy and intravitreal injection of vancomycin and ceftazidime were performed upon presentation. The vitreous sample culture was positive for C. koseri. The patient responded well with ultimate resolution of the infection and return of pre-infection visual acuity without a vitrectomy.

Hemorrhoidal disease (HD) is a prevalent anorectal disorder that affects up to 36% of the general population. It is characterized by symptomatic enlargement and displacement of anal cushions, frequently associated with pain, bleeding, and reduced quality of life. The pathophysiology of HD includes vascular congestion, venous stasis, and vascular dilatation, promoted by increased nitric oxide activity. Inflammatory responses are considered crucial in HD, with NF-κB playing a major role. Treatment strategies for HD vary from conservative approaches to office-based and surgical interventions. Conservative therapies, such as topical agents and flavonoid-based systemic treatments, serve as the mainstay of low-grade HD management, while invasive procedures are reserved for refractory cases. Topical formulations containing fluocinolone acetonide (FLA) and ketocaine hydrochloride (KH) combine anti-inflammatory and anesthetic effects, providing rapid and sustained relief from pain, itching, and inflammation. FLA exerts potent anti-inflammatory effects by inhibiting NF-κB and induces vasoconstrictive activity by reducing nitric oxide levels, while KH provides localized analgesia by blocking sodium channels. Collectively, these agents mitigate vascular congestion, inflammation, and HD symptoms. Clinical evidence supports the efficacy of this combination in alleviating acute symptoms, reducing recurrence, and improving patient outcomes. The FLA/KH formulation provides targeted local action with minimal systemic absorption and predominantly mild and transient adverse events. Treatment with FLA/KH is an effective and well-tolerated option for managing acute HD. Furthermore, its combination with flavonoid-based supplements, which improve venous tone and reduce capillary permeability, may aid in preventing recurrence. This combined approach leverages the rapid symptom relief provided by topical agents and the long-term benefits of systemic therapies, promoting comprehensive HD management and reducing the risk of recurrence.

Safety and efficacy profile of the fluocinolone acetonide implant in non-infectious uveitic macular edema: 5-year follow-up.

Postoperative cystoid macular edema (PCME) is a primary cause of reduced vision following both cataract and/or vitreoretinal surgery, which may spontaneously resolve. This study aimed to evaluate the effectiveness and safety of the fluocinolone acetonide intravitreal (FAc) implant (0.2µg/day) in patients with refractory PCME. Retrospective, non-interventional, and single center study conducted on patients with PCME treated with 0.2µg/day FAc implant. All the patients received previous treatment with topical corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), triancinolone injection and dexamethasone implant. The primary end-points were the mean change in best-corrected-visual-acuity (BCVA) and the proportion of patients gaining ≥ 15 letters from baseline to the last follow-up visit. The secondary endpoints included the mean CRT reduction and the mean intraocular pressure (IOP) during the 36 months study period. Eight eyes from 8 patients were included in the study. Median (95% Confidence-interval) BCVA was significantly improved from 60.0 (50.05-69.95) letters at baseline to 80.15 (77.25-85.00) letters at month-36, p = 0.043. At the last follow-up visit, 5 (62.5%) eyes gained ≥ 15 letters, without any eye experiencing a loss of BCVA compared to baseline. There was significant CRT reduction from baseline (median: 497.5μm; 95%CI: 380.0-596.0μm) to month-36 (Median: 252.0μm; 95%CI: 242.0-268.0μm); p = 0.012. Regarding safety, IOP remained stable from baseline (median: 14.5mmHg; 95%Confidence-interval: 12.0-23.0 mmHg) to the last follow-up visit (median: 13.5mmHg; 95% Confidence-interval: 9.0-19.0mm Hg); p = 0.123. The FAc implant significantly improved both visual and anatomic outcomes, and was effective in preventing recurrences, while maintaining a reasonable safety profile, in PCME refractory to intravitreal triancinolone and dexamethasone.

Sphingolipid metabolism (SM) is linked to acute myocardial infarction (AMI), but its role remains unclear. This study explored SM-related genes (SMRGs) in AMI to support clinical diagnosis. We analyzed datasets GSE48060 and GSE123342 to identify differentially expressed genes (DEGs) and key module genes. Protein-protein interaction (PPI) network analysis and machine learning were used to screen potential biomarkers, which were validated via receiver operating characteristic (ROC) curves and expression assessment. Further analyses included artificial neural networks (ANN), enrichment analysis, immune infiltration, drug prediction, and molecular docking. Single-cell RNA sequencing (scRNA-seq) identified key cell types and their functions. Biomarkers were validated via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Intersection of 95 DEGs and 2,196 module genes yielded 20 genes, with ANXA3 and SOCS3 identified as biomarkers. The ANN model showed superior diagnostic performance compared to individual markers. Biomarkers were enriched in the toll-like receptor (TLR) signaling pathway. Immune infiltration analysis revealed differences in five immune cell types between AMI and control groups. ANXA3 correlated positively with neutrophils and negatively with resting memory CD4 T cells. Drugs targeting ANXA3 included ethanolamine, difluocortolone, and fluocinolone acetonide, with strong binding affinity. scRNA-seq identified B cells and monocytes as key cells; ANXA3 and SOCS3 expression increased during monocyte differentiation before decreasing, while B cells showed no significant changes. ANXA3 and SOCS3 were identified as SM-related biomarkers in AMI, providing insights for clinical diagnosis.

Melasma management remains challenging due to its multifactorial nature pathogenesis and recurrent nature. Previous studies showed positive effects of botulinum toxin A (BoNT-A) for treating and preventing ultraviolet-induced hyperpigmentation. To evaluate the effectiveness of adjunctive incoBoNT-A injection combined with triple combination cream (TCC, 4% hydroquinone, 0.05% tretinoin, and 0.01% fluocinolone acetonide) for treating and preventing melasma recurrence compared to topical therapy alone. A split-face study was conducted in 30 female patients with melasma. One side of the face was randomly applied TCC to the melasma-affected areas for 12 weeks (monotherapy), while the contralateral side received TCC and intradermal incoBoNT-A at baseline and week 12 (combination therapy side). Evaluations were performed at baseline and 2, 4, 8, 12, 16, 20, and 24 weeks. Clinical improvement and melanin index were assessed using the MASI score on the malar area (MASIm), and Colorimeter respectively. Patient satisfaction was also evaluated. Twenty-eight subjects completed the study. The combination therapy side showed significant MASIm decrease at week 2 (p = 0.0032), while the monotherapy side showed no significant change. At 4 weeks, a greater reduction of MASIm was observed in the combination therapy side (MASIm 14.5 and 11.54, 20.41% reduction) when compared to the monotherapy side (MASIm 11.68 and 11.79, 0.93% worsening). At week 12, worsening of melasma was observed on both sides during the summer period. At week 24 (3 months after discontinuing TCC), MASIm was 14.79 on the monotherapy side (worsen 21.03% from baseline) and 9.14 on the combined technique (36.97% improvement, p = 0.0003). Patients' satisfaction was higher for the combination therapy when compared to the monotherapy at the end of the study (8.92 vs. 7.04, p < 0.0001). No serious adverse events occurred. Intradermal incoBoNT-A injection combined with TCC demonstrated superior efficacy in melasma treatment and recurrence prevention compared to TCC monotherapy.

PurposeTo compare the efficacy and safety between a first and a second injection of fluocinolone acetonide implants (FAc-I) in the treatment of diabetic macular oedema (DMO).MethodsThis retrospective, multicentre cohort study included eyes with chronic DMO that received two consecutive FAc-I injections. We analysed visual and anatomical outcomes, additional DMO treatments, and intraocular pressure (IOP)-related adverse events.ResultsWe included 61 eyes from 44 patients. Stable or improved BCVA was observed in 100% of eyes after the first injection and in 93% after the second, demonstrating statistical equivalence within a ±15% margin (p = 0.005). Statistical equivalence was also found for the lowest CRT (±10% margin, p < 0.001) and for the proportion of eyes with ≥20% CRT decrease (±20% margin, p = 0.026). The proportion of patients requiring additional treatments during the first year was equivalent between injections (p = 0.036), with a therapeutic burden reduction of 63% and 59%, respectively. Regarding peak IOP, equivalence was observed between the two injections (±5 mmHg margin, p < 0.001). The incidence of OHT was numerically higher after the second injection (19.7% vs 11.5%, p = 0.302), but this difference was not statistically significant.ConclusionMultiple FAc-I injections are a safe and effective treatment option for chronic DMO in real life. The second injection maintained similar functional and anatomical outcomes to the first, supporting the sustainability and repeatability of the treatment.

To described and evaluate a technique in which the fluocinolone acetonide 0.18mg implant is sutured into the pars plana in cases of noninfectious uveitis. Ocular vitals and slit lamp examination was performed at baseline, 1 month, 3 months, 6 months and 12 months follow up. Optical coherence tomography was obtained at all these visits. Data assessed included visual acuity; intraocular pressure; signs of active inflammation including anterior chamber cell, anterior chamber flare, vitreous cell, macular edema, as well as other forms of ocular inflammation; surgical complications; and need for additional interventions. 6 eyes of 6 patients had scleral fixation of the fluocinolone implant. The mean visual acuity remained stable between the visit prior to refixation and 12 months after scleral fixation (0.03 log MAR change, p = 0.92). The mean macular central subfield thickness decreased from the visit prior to refixation to 12 months after scleral fixation (252.4μm decrease, p = 0.38). No eyes required additional therapy to control posterior noninfectious uveitis or macular edema. In patients with aphakia, compromised zonules/posterior lens capsule, and anterior or scleral-fixated intraocular lenses, all of which are contraindications to injection of posterior segment implants, scleral fixation of the 0.18mg fluocinolone acetonide implant may be useful for treatment of noninfectious uveitis.

To compare the effect of fluocinolone acetonide (FA), mineral trioxide aggregate (MTA), and their combination on inflamed human dental pulp cells (HDPCs), focusing on cell viability, expression of inflammation and mineralisation-associated genes, and odontogenic differentiation. HDPCs were treated with 20µg/mL lipopolysaccharide (LPS) alone or in combination with and 400 µM hydrogen peroxide (H2O2) for 6, 12, 24 and 48h to induce inflammatory conditions. Normal and inflamed HDPCs were further treated with FA, MTA extraction medium, or a combination of MTA and FA. Cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The expression of inflammatory and mineralisation-associated genes was evaluated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Odontogenic differentiation was determined by alkaline phosphatase staining (ALP) and alizarin red S staining (ARS). HDPCs pretreated with LPS and H2O2 had reduced cell viability, increased expression of IL-1β and IL-6, decreased expression of ALP and DSPP, and reduced odontogenic differentiation. Treatment with FA alone or in combination with MTA improved these parameters, except for odontogenic differentiation, which was enhanced only in the FA-treated group. FA exerted anti-inflammatory properties and promoted odontogenic differentiation under the inflammatory milieus of HDPCs in this in vitro study. Under the simulated inflammatory condition of HDPCs, this in vitro study suggests the potential benefit of FA for anti-inflammatory and mineralisation enhancing properties.

To evaluate the effectiveness and safety of the fluocinolone acetonide implant (0.2 µ g/day fluocinolone acetonide, ILUVIEN) in macular edema due to retinal amyloid angiopathy in patients with hereditary transthyretin amyloidosis associated with the V30M mutation (ATTRV30M). Retrospective observational case series of ATTRV30M patients' eyes treated with the implant for macular edema, from January 2010 to December 2019. Best-corrected visual acuity, central foveal thickness, and intraocular pressure were measured at baseline, at 1 week, and at months 1, 3, 6, and 12. Fifteen eyes of 15 ATTRV30M patients with fluocinolone acetonide implants were included. All patients had already received a liver transplant. All had already been submitted to cataract surgery: 87% had an Ahmed valve implant, and 80% were vitrectomized due to vitreous amyloidosis. A statistically significant improvement in best-corrected visual acuity and in central foveal thickness at all time points was found compared with baseline. There was no statistically significant difference in intraocular pressure during the follow-up. Patients with macular edema due to retinal amyloid angiopathy treated with the fluocinolone acetonide implant showed sustained increased functional results and anatomical improvement compared with baseline.

We describe a simple technique for removing fluocinolone acetonide (FAc) implant using 25 G instrumentation in an eye with uncontrolled glaucoma. The technique involved freeing the implant from the pars plana, lifting it from the posterior pole with 25G+Grieshaber Maxgrip forceps and transferring it to another forceps. The implant was then realigned coaxially and successfully removed through a 25G cannula without getting it dislodged. Fluocinolone implant could be safely removed through 25 G cannula in toto, and removal resulted in good control of intraocular pressure at 3-month and 9-month follow-up. This innovative bimanual handshake technique to transfer and realign the implant coaxially is a quicker and safer way to remove FAc implant, which avoids removing the cannula and thereby retains all advantages of 25G cannula, including better sclerotomy closure.

Toxic disinfection byproducts (DBPs) formed during chlorination are a significant concern for drinking water safety. These compounds were analyzed using nontargeted methods, and their chemical formulas and structures were determined through tandem mass spectrometry combined with a novel fragmental chain characterization (FCC) algorithm. This FCC algorithm significantly improved annotation rates, achieving a four-fold increase compared to traditional mass spectral matching strategies. Transformation linkages were identified between precursor compounds and DBPs, based on their shared fragmental chains. Using this advanced nontargeted analysis approach, we identified organofluorine precursors as key contributors to the formation of toxic DBPs in chlorinated water. These findings were validated using chemical standards, including fluoroquinolone antibiotics (e.g., enrofloxacin and difloxacin) and fluorosteroids (e.g., fluocinolone acetonide and triamcinolone). Fluoroquinolone-derived DBPs were found to be 2.5 times more toxic after chlorination, exceeding the 1.5 times overall toxicity increase observed in actual water samples. Fluorosteroids showed smaller toxicity increases (1.3-1.5 times), but their conversion rates in real water were 1.7-2.3 times higher than in laboratory conditions. This study highlights the role of organofluorine precursors in DBP formation and provides an innovative method to identify unknown DBPs, elucidate their formation pathways, and trace their sources, advancing water treatment safety.

To describe effects of sustained-release steroid delivery devices on intraocular pressure (IOP) in eyes with glaucoma drainage devices. Retrospective case series of eyes with steroid implants (dexamethasone or fluocinolone acetonide) and prior glaucoma drainage devices (Ahmed, Baerveldt) without uveitis. Outcomes included IOP, IOP rise, central foveal thickness, and IOP medications. We included 14 eyes (14 patients, 38% men, 94% pseudophakic). Mean age at steroid implantation was 64 ± 12 years. Baerveldt (64%) was more common than Ahmed (36%). Tubes were in the anterior chamber (57.1%), sulcus (28.6%), and pars plana (14.3%). Ozurdex (93%) was more common than Yutiq (7%). Mean IOP was 13.5 ± 3.4 mmHg preimplant, 11.8 ± 3.7 mmHg at month 1, 13.3 ± 3.6 mmHg at month 3 ( P = 0.35), and 11.3 ± 3.8 mmHg at 1 year ( P = 0.032). Mean antihypertensive medication was unchanged at month 3 ( P = 1.0) and -0.36 medication at last follow-up ( P = 0.35). Mean central foveal thickness change was -204 ± 158 µ m ( P = 0.001). There were no cases of endophthalmitis. Intravitreal steroid implants were safe and effective for the treatment of postsurgical CME in patients with pre-existing glaucoma drainage devices. There was no increase in IOP and no increase in antihypertensive drops.

Treatment with fluocinolone acetonide, hydroquinone, and tretinoin cream is the gold standard for melasma; however, the effects of this treatment in the Chinese population remain unclear. Due to the differences between Chinese and Caucasian subjects, further clinical trials in Chinese patients with melasma are needed. To evaluate the efficacy and safety of fluocinolone acetonide, hydroquinone, and tretinoin creams in Chinese patients with moderate-to-severe melasma. We recruited 53 patients who received a generic formulation (triple combination cream, TCC), brand formulation (TRI-LUMA), or placebo once daily for 8 weeks. In weeks 4 and 8, efficacy was evaluated based on the Melasma Severity Scale and Melasma Area and Severity Index. In addition, safety was assessed based on the incidence and severity of treatment-emergent adverse events. The generic TCC group achieved 52.2% efficacy compared to 57.1% in the TRI-LUMA group. There was no significant difference in the incidence of adverse effects between the TCC and TRI-LUMA groups (69.6% and 90.5%, respectively; p > 0.05). The incidence of adverse events in the placebo group was 0%. Generic TCC was as effective as TRI-LUMA and had a similar safety profile in this study of Chinese subjects with moderate-to-severe melasma.

Background/Objectives: Chronic macular edema (CME) is a common complication of diabetic retinopathy or non-infectious uveitis affecting the posterior segment (NIU-PS). Alongside anti-VEGF therapy, glucocorticoids are frequently used to manage CME. Given the heterogeneous nature of patients' medical history, their social conditions, and disease manifestations, individualized treatment is essential for optimal outcomes. This study assesses the effectiveness of intravitreal fluocinolone acetonide (FA) (Iluvien®) in treating persistent and recurrent macular edema in clinical practice at the University Hospital of Erlangen-Nuremberg, Germany. Methods: A total of 46 eyes with diabetic macular edema (DME) (21 eyes) and NIU-PS (25 eyes) were retrospectively analyzed over a follow-up period of up to 36 months. Since persistent retinal thickness fluctuations are linked to long-term retinal damage and functional decline, this study analyzed central retinal thickness (CRT)-including its fluctuations measured as CRT amplitude-alongside BCVA as the primary outcomes. Results: After an initial decrease in CRT in the first year after FA treatment, the maximum CRT amplitude significantly decreased in the following years. For patients with DME, CRT amplitude reduced from 271.4 µm to 91.57 µm in the first year (p = 0.0056) and 106.0 µm in the second year (p = 0.0109). For patients with NIU-PS, CRT amplitude decreased from 185.2 µm to 87.7 µm in the first year (p = 0.0131) and 97.3 µm in the second year (p = 0.0375). Mean BCVA remained stable in both cohorts. Conclusions: Intravitreal FA proved to be effective in reducing and stabilizing CRT in patients with chronic DME and NIU-PS without losing visual acuity, reducing treatment burden.

Purpose: To describe a case of occlusive retinal vasculitis (ORV) following intravitreal aflibercept 8mg injection for wet macular degeneration. Methods: Retrospective, interventional case report Results: A 72-year-old female presented with classic ORV 11 days after intravitreal aflibercept 8mg injection in her left eye for wet macular degeneration. Visual acuity (VA) declined from 20/30 to 20/400. Laboratory investigations including Gram stain and cultures of vitreous aspirate, studies for infectious and non-infectious uveitis and hypercoagulable state were all negative. Oral prednisone, sub-Tenon’s triamcinolone acetonide (STTA), intravitreal dexamethasone and antibiotic injections, and topical steroids resulted in visual and anatomic improvement. ORV recurred when prednisone was tapered to 10mg/day and was controlled with additional STTA, oral solumedrol, and a 0.18mg fluocinolone acetonide implant. Subsequently exudation from wet macular degeneration recurred and responded to intravitreal faricimab with recovery to 20/30. Conclusions: ORV is a rare complication of some intravitreal anti-VEGF medications and infectious causes of endophthalmitis. It can be managed with aggressive steroid treatment for an excellent visual outcome in some cases, although the disease may be chronic or recurrent.

To identify full-field electroretinographic (ffERG) biomarkers that differentiate active versus inactive birdshot chorioretinopathy (BSCR) and long-term efficacy of intravitreal versus systemic immunosuppression. Patients with BSCR at Casey Eye Institute with ffERG between 1999-2019 were included (n = 29). A group of healthy patients was used as controls (n = 47). Patients with BSCR were categorized as active or inactive based on the uveitis specialist's clinical assessment. Cross-sectional comparison of ffERG markers between active, inactive, and control patients was performed, in addition to rate analysis of ffERG metrics in BSCR eyes treated with either intravitreal fluocinolone acetonide 0.59 mg (IVFAI) or systemic immunomodulation (SI). Both active and inactive BSCR tended to have lower amplitude and slower timing than controls, but only 30 Hz flicker time (p < 0.001, p < 0.01) and dim scotopic b-wave amplitude (p < 0.001, p < 0.05) were significant. Timing for inactive BSCR was faster than active for bright scotopic a-wave (p < 0.01), photopic b-wave (p < 0.01), and 30 Hz flicker (p < 0.01). Eyes treated with SI showed improvement in dim scotopic b-wave amplitude compared to a decline for IVFAI (p < 0.05), whereas eyes treated with SI showed slower degradation of bright scotopic b-wave amplitude (p < 0.01). Conversely, eyes treated with IVFAI showed greater improvement in bright scotopic (p < 0.05) and photopic a-wave timing (p < 0.01). Timing of 30 Hz flicker, bright scotopic a-wave, and photopic b-wave may be useful biomarkers for disease activity in BSCR. Moreover, both SI and IVFAI were effective in preserving retinal function to varying degrees.

ABSTRACT Purpose To evaluate time to first additional treatment following intravitreal 0.19 mg fluocinolone acetonide (FAc) in non-infectious uveitis with posterior segment involvement (NIU-PS) in a real-world setting. Methods Prospective observational study on 37 eyes (30 patients) with chronic or recurrent NIU-PS, treated with FAc after achieving control – indicated by absence of vitreous haze or clearly visible posterior pole. Over a median follow-up of 48.0 ± 0.0 months, we assessed time to and number of additional treatments, inflammatory activity, central subfield macular thickness (CSMT), visual acuity (VA) and intraocular pressure (IOP). Results Restricted mean time to first adjuvant treatment was 31.9 ± 2.97 months, with 52.8% requiring no additional treatment ≥ 48 months. VA remained stable (baseline 0.56 ± 0.44 logMAR, p = 0.86). A negative correlation was found between the number of prior steroid implants (DEX-I) and time to additional treatment (r = −0.44, p = 0.001). For up to 24 months, FAc reduced anterior chamber flare (0.44 ± 0.81 to 0.00 ± 0.00, p < 0.001), vitreous haze (0.28 ± 0.51 to 0.00 ± 0.00, p = 0.01), and CSMT (407.1 ± 135.9 µm at baseline to 324.2 ± 75.7 µm at M24, p = 0.001). Within 48 months, ocular hypertension (≥25 mmHg) occurred in 22.2% of eyes (8/36), with 19.4% (7/36) requiring new-onset IOP-lowering drops. Conclusion FAc demonstrated efficacy in managing low-grade NIU-PS, reducing the need for additional treatments and controlling intraocular inflammation for an average of 32 months.