FLUOCINOLONE ACETONIDE IMPLANT FOR VOGT-KOYANAGI-HARADA DISEASE: Three-Year Outcomes of Efficacy and Safety.

ABSTRACT

PURPOSE: To investigate the efficacy and safety of fluocinolone acetonide intravitreal implant in patients with Vogt-Koyanagi-Harada disease. METHODS: A post hoc, subgroup analysis on patients with Vogt-Koyanagi-Harada was performed using data sets from two multicenter randomized trials on fluocinolone acetonide implant. Each subject received fluocinolone acetonide implantation in one eye and standard-of-care treatment in the fellow eye and was followed for 3 years. RESULTS: Thirty patients were included with the mean age of 38.5 years. The cumulative rate of uveitis recurrence for 3 years was significantly reduced in implanted eyes compared with fellow eyes (33 vs. 87%; P < 0.001). The reduction of daily corticosteroid dose was well maintained (12.8 mg before implantation vs. 3.7 mg after implantation; P = 0.001), but final vision was similar to preoperative vision in the implanted eyes (P = 0.082) and in the fellow eyes (P = 0.187). Postoperative elevation of intraocular pressure was more frequent in the implanted eyes than in the fellow eyes (70 vs. 20%; P < 0.001). Cataract progression occurred in all phakic implanted eyes. CONCLUSION: Fluocinolone acetonide intravitreal implant reduced uveitis recurrence rate and the dosage of systemic corticosteroid and immunosuppressant requirement in patients with Vogt-Koyanagi-Harada. However, cataract and intraocular pressure elevation developed frequently.