Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone

Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone

Marta Zola, Cristina Briamonte, Umberto Lorenzi, Federica Machetta, Federico M Grignolo, Antonio M Fea Ophthalmic Eye Hospital, Department of Surgical Sciences, University of Turin, Italy Purpose: The purpose of this study was to report the functional and anatomical outcomes of a prospective study...

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Autores principales: Zola M, Briamonte C, Lorenzi U, Machetta F, Grignolo FM, Fea AM
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2017
Materias:
uveitis
macular edema
dexamethasone
intavitreal implant
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/6fa323311f874133aa3a95f4be4a7fa9
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spelling oai:doaj.org-article:6fa323311f874133aa3a95f4be4a7fa92021-12-02T07:09:16ZTreatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone1177-5483https://doaj.org/article/6fa323311f874133aa3a95f4be4a7fa92017-11-01T00:00:00Zhttps://www.dovepress.com/treatment-of-refractory-uveitic-macular-edema-results-of-a-first-and-s-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Marta Zola, Cristina Briamonte, Umberto Lorenzi, Federica Machetta, Federico M Grignolo, Antonio M Fea Ophthalmic Eye Hospital, Department of Surgical Sciences, University of Turin, Italy Purpose: The purpose of this study was to report the functional and anatomical outcomes of a prospective study resulting from repeated dexamethasone intravitreal implants in patients with uveitic refractory macular edema.Methods: Twelve eyes of 9 patients with intermediate and posterior noninfectious inflammatory uveitis complicated with refractory macular edema were regularly reviewed after a dexamethasone intravitreal implant. Patients were examined at baseline, 30, 90, 135, and 180 days with best-corrected visual acuity (BCVA), complete slit-lamp examination, intraocular pressure (IOP), optical coherence tomography, and fluorescein angiography. After 6 months of follow-up, eyes were reassessed to receive a second implant. Results: BCVA significantly improved when comparing the baseline values after the first and second implant (16.2 and 25.8 letters, respectively, 9.6 letters improvements, p<0.05). BCVA was better after the second implant compared to the first one throughout the follow-up, but without statistical significance. Mean central macular thickness (CMT) was 446.3±129.9 µm at baseline and was significantly reduced until day 135 (p<0.05). CMT reductions after the second injection showed a similar pattern, though differences were not statistically significant. Cataract progression was observed in 4 of 8 phakic eyes (50%) after the first implant, and in 2 of 3 phakic eyes following the second implant, with 1 eye requiring cataract surgery. One eye developed an IOP >30 mmHg 30 days after the second implant, treated topically.Conclusion: Repeated dexamethasone intravitreal implants in uveitic patients with refractory macular edema can be used effectively in a clinical setting with an acceptable safety profile. Keywords: uveitis, macular edema, dexamethasone, intavitreal implantZola MBriamonte CLorenzi UMachetta FGrignolo FMFea AMDove Medical Pressarticleuveitismacular edemadexamethasoneintavitreal implantOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1949-1956 (2017)
institution DOAJ
collection DOAJ
language EN
topic uveitis
macular edema
dexamethasone
intavitreal implant
Ophthalmology
RE1-994
spellingShingle uveitis
macular edema
dexamethasone
intavitreal implant
Ophthalmology
RE1-994
Zola M
Briamonte C
Lorenzi U
Machetta F
Grignolo FM
Fea AM
Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
description Marta Zola, Cristina Briamonte, Umberto Lorenzi, Federica Machetta, Federico M Grignolo, Antonio M Fea Ophthalmic Eye Hospital, Department of Surgical Sciences, University of Turin, Italy Purpose: The purpose of this study was to report the functional and anatomical outcomes of a prospective study resulting from repeated dexamethasone intravitreal implants in patients with uveitic refractory macular edema.Methods: Twelve eyes of 9 patients with intermediate and posterior noninfectious inflammatory uveitis complicated with refractory macular edema were regularly reviewed after a dexamethasone intravitreal implant. Patients were examined at baseline, 30, 90, 135, and 180 days with best-corrected visual acuity (BCVA), complete slit-lamp examination, intraocular pressure (IOP), optical coherence tomography, and fluorescein angiography. After 6 months of follow-up, eyes were reassessed to receive a second implant. Results: BCVA significantly improved when comparing the baseline values after the first and second implant (16.2 and 25.8 letters, respectively, 9.6 letters improvements, p<0.05). BCVA was better after the second implant compared to the first one throughout the follow-up, but without statistical significance. Mean central macular thickness (CMT) was 446.3±129.9 µm at baseline and was significantly reduced until day 135 (p<0.05). CMT reductions after the second injection showed a similar pattern, though differences were not statistically significant. Cataract progression was observed in 4 of 8 phakic eyes (50%) after the first implant, and in 2 of 3 phakic eyes following the second implant, with 1 eye requiring cataract surgery. One eye developed an IOP >30 mmHg 30 days after the second implant, treated topically.Conclusion: Repeated dexamethasone intravitreal implants in uveitic patients with refractory macular edema can be used effectively in a clinical setting with an acceptable safety profile. Keywords: uveitis, macular edema, dexamethasone, intavitreal implant
format article
author Zola M
Briamonte C
Lorenzi U
Machetta F
Grignolo FM
Fea AM
author_facet Zola M
Briamonte C
Lorenzi U
Machetta F
Grignolo FM
Fea AM
author_sort Zola M
title Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_short Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_full Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_fullStr Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_full_unstemmed Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_sort treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/6fa323311f874133aa3a95f4be4a7fa9
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