The efficacy and safety of ozurdex intravitreal implant for the treatment of noninfectious intermediate uveitis
What:
Paper Presentation | Présentation d'article
Part of:
When:
4:34 PM, Friday 1 Jun 2018
(12 minutes)
Where:
How:
Authors: Solin Saleh, Chris Welsh, Chloe Gottlieb
Author Disclosure Block: S. Saleh: None. C. Welsh: None. C. Gottlieb: None.
Abstract Body:
Purpose: Ozurdex (Allergan, Inc, Irvine, California) is a sustained-release intravitreal dexamethasone implant that delivers corticosteroid directly to the posterior segment of the eye, allowing for controlled drug release over approximately 6 months. To date, few studies have been carried out to assess the role of Ozurdex in patients with exclusively non-infectious intermediate uveitis. The purpose of this study is to evaluate the efficacy and safety of the Ozurdex intravitreal implant for the treatment of non-infectious intermediate uveitis in patients on systemic immunosuppressive therapy and those naïve to systemic therapies.
Study Design: Case series.
Methods: Retrospective review of demographic information, clinical data and optical coherence tomography (OCT) scans from patients with non-infectious intermediate uveitis treated with Ozurdex at the University of Ottawa Eye Institute between September 1, 2010 and December 1, 2016. Demographics and clinical information, including pre- and post-treatment best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber and vitreous inflammation following SUN grading, and central retinal thickness (CRT) and presence of cystoid macular edema (CME) on OCT were analyzed.
Results: The charts of 22 patients and 33 eyes with at least 6 months of follow up after Ozurdex implant were included. Mean age was 45.09 years, and 15 patients were female. Nine out of 22 patients (40.9%) were on systemic immunosuppressive therapy. Mean pre- and 6-month post-treatment BCVA was ~20/35 (0.225 logMAR) and ~20/25 (0.130 logMAR), respectively (p=0.038). Mean pre- and post-treatment CRT was 383.3 microns and 294.8 microns, respectively (p=0.00013). At the last follow-up appointment, there was resolution of CME in 83.3% of patients. At 6 months post-treatment, 88.0% had anterior chamber cell resolution, 84.6% had anterior chamber flare resolution, 78.6% had vitreous cell resolution, and 66.7% had vitreous haze resolution. Complete resolution of all intraocular inflammation was seen in 63.6% of our sample. IOP was not significantly raised post-treatment. Adverse events after Ozurdex injection included blurred vision in 57.6%, floaters in 54.5%, and photophobia in 15.2%. These had resolved at the last follow-up appointment in greater than 80% of the patients.
Conclusions: The Ozurdex intravitreal dexamethasone implant was effective in treating intermediate uveitis in our study group with statistically significant improvements in BCVA and CRT at 6 months follow up. Most patients in this study had complete resolution of their intraocular inflammation. Adverse effects were difficult to attribute to either the treatment or disease process, but most had resolved by the last follow-up appointment. Ozurdex appears to be a safe and effective treatment for non-infectious intermediate uveitis.
Author Disclosure Block: S. Saleh: None. C. Welsh: None. C. Gottlieb: None.
Abstract Body:
Purpose: Ozurdex (Allergan, Inc, Irvine, California) is a sustained-release intravitreal dexamethasone implant that delivers corticosteroid directly to the posterior segment of the eye, allowing for controlled drug release over approximately 6 months. To date, few studies have been carried out to assess the role of Ozurdex in patients with exclusively non-infectious intermediate uveitis. The purpose of this study is to evaluate the efficacy and safety of the Ozurdex intravitreal implant for the treatment of non-infectious intermediate uveitis in patients on systemic immunosuppressive therapy and those naïve to systemic therapies.
Study Design: Case series.
Methods: Retrospective review of demographic information, clinical data and optical coherence tomography (OCT) scans from patients with non-infectious intermediate uveitis treated with Ozurdex at the University of Ottawa Eye Institute between September 1, 2010 and December 1, 2016. Demographics and clinical information, including pre- and post-treatment best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber and vitreous inflammation following SUN grading, and central retinal thickness (CRT) and presence of cystoid macular edema (CME) on OCT were analyzed.
Results: The charts of 22 patients and 33 eyes with at least 6 months of follow up after Ozurdex implant were included. Mean age was 45.09 years, and 15 patients were female. Nine out of 22 patients (40.9%) were on systemic immunosuppressive therapy. Mean pre- and 6-month post-treatment BCVA was ~20/35 (0.225 logMAR) and ~20/25 (0.130 logMAR), respectively (p=0.038). Mean pre- and post-treatment CRT was 383.3 microns and 294.8 microns, respectively (p=0.00013). At the last follow-up appointment, there was resolution of CME in 83.3% of patients. At 6 months post-treatment, 88.0% had anterior chamber cell resolution, 84.6% had anterior chamber flare resolution, 78.6% had vitreous cell resolution, and 66.7% had vitreous haze resolution. Complete resolution of all intraocular inflammation was seen in 63.6% of our sample. IOP was not significantly raised post-treatment. Adverse events after Ozurdex injection included blurred vision in 57.6%, floaters in 54.5%, and photophobia in 15.2%. These had resolved at the last follow-up appointment in greater than 80% of the patients.
Conclusions: The Ozurdex intravitreal dexamethasone implant was effective in treating intermediate uveitis in our study group with statistically significant improvements in BCVA and CRT at 6 months follow up. Most patients in this study had complete resolution of their intraocular inflammation. Adverse effects were difficult to attribute to either the treatment or disease process, but most had resolved by the last follow-up appointment. Ozurdex appears to be a safe and effective treatment for non-infectious intermediate uveitis.
