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Am J Ophthalmol ; 158(6): 1136-1145.e5, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25217856

RESUMEN

PURPOSE: To identify clinical outcomes and treatment patterns of intravitreal dexamethasone implant (Ozurdex; Allergan, Inc) in noninfectious uveitis in the clinical setting. DESIGN: Multicenter retrospective cohort study. METHODS: Eighty-two eyes (63 patients) receiving 142 implant injections over 35 months were included. Treatment indication, uveitis diagnosis, visual acuity, intraocular pressure, vitreous haze score, central retinal thickness by optical coherence tomography, phakic status, number of injections, time to reinjection, systemic treatments, and complications data were collected. Time to visual acuity and vitreous haze score improvement as per the Standardization of Uveitis Nomenclature guidelines were also determined. RESULTS: The probability of visual acuity improvement (≥0.3 logarithm of the minimal angle of resolution units improvement) was 39% at 1 month, 49% at 3 months, 52% at 6 months, and 58% at 12 months. Eyes with baseline vitritis (vitreous haze score ≥+0.5, n = 45) had a probability of vitreous haze score improvement (2-step decrease or change from +0.5 to 0) at 2 weeks of 41%, at 1 month 63%, at 3 months 73%, at 6 months 79%, and at 12 months 88%. In eyes that completed 12-month follow-up (n = 54), 40.7% underwent 2 injections (mean time to second injection of 6.6 ± 1.9 months) and 11.2% required ≥3 injections (mean time to third injection of 11 ± 1.5 months). CONCLUSIONS: Dexamethasone implant use in uveitis provides favorable visual acuity and vitreous haze score outcomes but requires repeated injections, an important consideration when choosing intraocular treatment as a route to controlling uveitis.


Asunto(s)
Dexametasona/administración & dosificación , Glucocorticoides/administración & dosificación , Uveítis/tratamiento farmacológico , Adulto , Anciano , Estudios de Cohortes , Dexametasona/efectos adversos , Implantes de Medicamentos , Femenino , Glucocorticoides/efectos adversos , Humanos , Presión Intraocular/efectos de los fármacos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Retina/patología , Retratamiento , Estudios Retrospectivos , Resultado del Tratamiento , Uveítis/diagnóstico , Agudeza Visual/efectos de los fármacos , Cuerpo Vítreo/efectos de los fármacos
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