Single Dexamethasone Intravitreal Implant in the Treatment of Noninfectious Uveitis

Purpose: To investigate the effect of a single intravitreal dexamethasone implant (IVT-DI; Ozurdex; Allergan, Inc.) on visual acuity, macular thickness, and intraocular pressure (IOP) in active noninfectious uveitis. Methods: Medical records of patients with noninfectious active uveitis treated by IVT-DIs were retrospectively reviewed. Uveitis etiologies, treatment indications, best corrected visual acuity (BCVA), central retinal thickness measured by ocular coherence tomography, IOP, and systemic, local, and topical treatments were collected. Parameters were analyzed before the injection of the implant, after 1.5 +/- 0.8 months and 4.4 +/- 0.9 months for the BCVA, after 2 +/- 1.3 months and 4.6 +/- 1.3 months for the ocular coherence tomography, and after 1.3 +/- 0.7 months and 4.4 +/- 1 months for the IOP. Results: We included 14 patients (20 eyes, 20 implant injections) with cystoid macular edema (78%), vasculitis (7%), choroiditis (7%), and vasculitis associated with choroiditis (7%). Before the injection, mean visual acuity was 0.4 +/- 0.5 logMAR (logarithm of the minimum angle of resolution) that improved to 0.3 +/- 0.5 logMAR (P = 0.0002) after 1.5 +/- 0.8 months and to 0.3 +/- 0.5 logMAR (P = 0.005) after 4.4 +/- 0.9 months. A statistically significant decrease of macular thickness was observed both at 2 +/- 1.3 months and at 4.6 +/- 1.3 months after IVT-DI. Mean IOP was 16 +/- 5 mmHg before injections, 18 +/- 6 mmHg (P = 0.13) at 1.3 +/- 0.7 months, and 15 +/- 4 mmHg (P = 0.65) at 4.4 +/- 1 months. By Kaplan-Meier analysis, we found that after 3.3 months, 17% of the eyes still present a BCVA amelioration >= 0.3 logMAR. Conclusions: In our patients with active noninfectious uveitis, injection of a first single dexamethasone implant was found to improve visual acuity and decrease macular thickness without significant increase of IOP, although the effect seems limited in time.