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Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone

PURPOSE: The purpose of this study was to report the functional and anatomical outcomes of a prospective study resulting from repeated dexamethasone intravitreal implants in patients with uveitic refractory macular edema. METHODS: Twelve eyes of 9 patients with intermediate and posterior noninfectio...

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Autores principales: Zola, Marta, Briamonte, Cristina, Lorenzi, Umberto, Machetta, Federica, Grignolo, Federico M, Fea, Antonio M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685094/
https://www.ncbi.nlm.nih.gov/pubmed/29184384
http://dx.doi.org/10.2147/OPTH.S141153
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author Zola, Marta
Briamonte, Cristina
Lorenzi, Umberto
Machetta, Federica
Grignolo, Federico M
Fea, Antonio M
author_facet Zola, Marta
Briamonte, Cristina
Lorenzi, Umberto
Machetta, Federica
Grignolo, Federico M
Fea, Antonio M
author_sort Zola, Marta
collection PubMed
description PURPOSE: The purpose of this study was to report the functional and anatomical outcomes of a prospective study resulting from repeated dexamethasone intravitreal implants in patients with uveitic refractory macular edema. METHODS: Twelve eyes of 9 patients with intermediate and posterior noninfectious inflammatory uveitis complicated with refractory macular edema were regularly reviewed after a dexamethasone intravitreal implant. Patients were examined at baseline, 30, 90, 135, and 180 days with best-corrected visual acuity (BCVA), complete slit-lamp examination, intraocular pressure (IOP), optical coherence tomography, and fluorescein angiography. After 6 months of follow-up, eyes were reassessed to receive a second implant. RESULTS: BCVA significantly improved when comparing the baseline values after the first and second implant (16.2 and 25.8 letters, respectively, 9.6 letters improvements, p<0.05). BCVA was better after the second implant compared to the first one throughout the follow-up, but without statistical significance. Mean central macular thickness (CMT) was 446.3±129.9 μm at baseline and was significantly reduced until day 135 (p<0.05). CMT reductions after the second injection showed a similar pattern, though differences were not statistically significant. Cataract progression was observed in 4 of 8 phakic eyes (50%) after the first implant, and in 2 of 3 phakic eyes following the second implant, with 1 eye requiring cataract surgery. One eye developed an IOP >30 mmHg 30 days after the second implant, treated topically. CONCLUSION: Repeated dexamethasone intravitreal implants in uveitic patients with refractory macular edema can be used effectively in a clinical setting with an acceptable safety profile.
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spelling pubmed-56850942017-11-28 Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone Zola, Marta Briamonte, Cristina Lorenzi, Umberto Machetta, Federica Grignolo, Federico M Fea, Antonio M Clin Ophthalmol Original Research PURPOSE: The purpose of this study was to report the functional and anatomical outcomes of a prospective study resulting from repeated dexamethasone intravitreal implants in patients with uveitic refractory macular edema. METHODS: Twelve eyes of 9 patients with intermediate and posterior noninfectious inflammatory uveitis complicated with refractory macular edema were regularly reviewed after a dexamethasone intravitreal implant. Patients were examined at baseline, 30, 90, 135, and 180 days with best-corrected visual acuity (BCVA), complete slit-lamp examination, intraocular pressure (IOP), optical coherence tomography, and fluorescein angiography. After 6 months of follow-up, eyes were reassessed to receive a second implant. RESULTS: BCVA significantly improved when comparing the baseline values after the first and second implant (16.2 and 25.8 letters, respectively, 9.6 letters improvements, p<0.05). BCVA was better after the second implant compared to the first one throughout the follow-up, but without statistical significance. Mean central macular thickness (CMT) was 446.3±129.9 μm at baseline and was significantly reduced until day 135 (p<0.05). CMT reductions after the second injection showed a similar pattern, though differences were not statistically significant. Cataract progression was observed in 4 of 8 phakic eyes (50%) after the first implant, and in 2 of 3 phakic eyes following the second implant, with 1 eye requiring cataract surgery. One eye developed an IOP >30 mmHg 30 days after the second implant, treated topically. CONCLUSION: Repeated dexamethasone intravitreal implants in uveitic patients with refractory macular edema can be used effectively in a clinical setting with an acceptable safety profile. Dove Medical Press 2017-11-06 /pmc/articles/PMC5685094/ /pubmed/29184384 http://dx.doi.org/10.2147/OPTH.S141153 Text en © 2017 Zola et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Zola, Marta
Briamonte, Cristina
Lorenzi, Umberto
Machetta, Federica
Grignolo, Federico M
Fea, Antonio M
Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_full Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_fullStr Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_full_unstemmed Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_short Treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
title_sort treatment of refractory uveitic macular edema: results of a first and second implant of long-acting intravitreal dexamethasone
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685094/
https://www.ncbi.nlm.nih.gov/pubmed/29184384
http://dx.doi.org/10.2147/OPTH.S141153
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