Systemic Steroid Sparing Effect of Intravitreal Dexamethasone Implant in Chronic Noninfectious Uveitic Macular Edema

作者：Fabiani Claudia^*; Vitale Antonio; Emmi Giacomo; Lopalco Giuseppe; Vannozzi Lorenzo; Bacherini Daniela; Guerriero Silvana; Favale Rosa Anna; Fusco Fiorella; Franceschini Rossella; Frediani Bruno; Iannone Florenzo; Galeazzi Mauro; Tosi Gian Marco; Cantarini Luca^*

来源：Journal of Ocular Pharmacology and Therapeutics, 2017, 33(7): 549-555.

DOI：10.1089/jop.2017.0034

• dexamethasone
• intravitreal implant
• uveitis
• macular edema
• steroid sparing effect

Purpose: To evaluate the effectiveness and the systemic corticosteroid sparing effect of a single intravitreal dexamethasone (DEX) implant in patients with chronic noninfectious uveitic macular edema (UME).
Methods: Data from 22 eyes treated with DEX implant for UME related to systemic or ocular-confined noninfectious diseases were retrospectively analyzed.
Results: The mean systemic prednisone (or equivalent) dosage significantly decreased at 3- and 6-month follow-up evaluations compared to baseline (P = 0.002 and P = 0.01, respectively). Compared to baseline, central macular thickness values significantly decreased at 1-, 3-, and 6-month evaluations after the implantation (P < 0.0001). The mean best corrected visual acuity (BCVA) value gradually improved at 1-, 3-, and 6-month visits compared to baseline (P = 0.009, P = 0.0004, and P = 0.0001, respectively). At fluorescein angiography, active retinal vasculitis was identified in 11 (50%) eyes at baseline, 3 (13.6%) eyes at 1- and 3-month follow-up, and in 2 (9.1%) eyes at the last visit. Regarding side effects, 3/22 (13.6%) eyes presented a newly recognized intraocular hypertension at 1-month follow-up; however, intraocular pressure reverted to normal values within the 6-month follow-up in all cases.
Conclusions: Treatment with intravitreal DEX implant in noninfectious uveitis allowed a significant corticosteroid sparing effect, a significant improvement in BCVA, and a prompt resolution of UME and vasculitis. No safety issues were observed.

• 出版日期2017-9