Treatment of Non-Infectious Posterior Uveitis with Dexamethasone Intravitreal Implants in a Real-World Setting

Abstract

Purpose

The present study aimed to assess the efficacy and safety associated to the treatment of patients with non-infectious posterior uveitis with intravitreal dexamethasone (DEX) implants in a real-world clinical setting.

Patients and Methods

This is a retrospective, single center analysis of the data from 29 patients with non-infectious posterior uveitis in whom 38 eyes were treated with dexamethasone intravitreal implants in routine clinical practice between January 2012 and October 2017. The parameters of visual acuity (VA), intraocular pressure (IOP) and central retinal thickness (CRT) were recorded 6 weeks after the first implant was administered, in accordance with the clinical guidelines for the use of these implants, and after a 6-month follow-up period. In addition, the formation of cataracts was evaluated at 12 months.

Results

Treatment with the DEX implant caused a significant improvement in the VA from baseline at 6 weeks in eyes treated with 2–6 implants and for eyes without cataracts. A significant decrease in CRT was observed relative to the baseline at 6 weeks for eyes treated with 1 and 2–6 implants, which was maintained at 6 months for those eyes treated with 2–6 implants. This significant improvement in CRT at 6 weeks and 6 months was evident in eyes with and without cataracts. During the study period, the IOP was found to increase significantly from baseline at 6 weeks in some eyes but this was managed topically, and no surgical intervention was necessary.

Conclusion

Intravitreal DEX implants represent an effective and safe therapy for the treatment of non-infectious uveitis in routine clinical practice, producing favorable visual and anatomical outcomes after the administration of just 2–6 DEX implants.

Keywords:

• visual acuity
• intraocular pressure
• central retinal thickness
• cataracts
• retrospective analysis

Abbreviations

AE, adverse event; BRVO, Branch Retinal Vein Occlusion; CF, counting fingers; CME, cystoid macular edema; CRT, central retinal thickness; CRVO, Central Retinal Vein Occlusion; DEX, Dexamethasone; DME, diabetic macular edema; EMA, European Medicines Agency; FA, fluocinolone acetonide; FDA, US Food and Drug Administration; HM, hand movement; IOP, intraocular pressure; ME, macular edema; NSAIDs, non-steroidal anti-inflammatory drugs; OCT, optical coherence tomography; PI, peripheral iridotomy; RVO, Retinal Vein Occlusion; TA, triamcinolone acetonide; VA, visual acuity.

Data Sharing Statement

All the data included in this work will be made available upon reasonable request to the authors.

Ethics Approval and Informed Consent

This was a retrospective study carried out on data obtained from patients who had previously provided their informed consent for their data to be used in accordance with the Helsinki Declaration for medical research involving human subjects. This non-interventional audit study used data from the standard UK NHS system to manage electronic medical records (Medisoft), such that according to national law ethical approval is not required.

Acknowledgments

The authors would like to acknowledge the assistance of the staff at the Ophthalmology Department of the Bradford Infirmary in carrying out this work, and the patient’s that willingly participated in the study.

Disclosure

Miss Helen Devonport reports having received personal fees from Abbvie outside the submitted work. The author reports no other conflicts of interest in this work.

Additional information

Funding

The authors received an unrestricted grant from Abbvie to assist them with the preparation of the manuscript (medical writing) and to cover the costs of publication. In no way has this party influenced the data collection or the interpretation of the data, and they have not influenced the decision to publish the manuscript or its preparation.