Dexamethasone Intravitreal Implant in the Treatment of Persistent Uveitic Macular Edema in the Absence of Active Inflammation

Purpose: To examine the observational effectiveness of the dexamethasone (DEX) intravitreal implant (Ozurdex; Allergan, Inc., Irvine, CA) in the treatment of noninfectious uveitic macular edema in patients with otherwise quiescent uveitis. Design: Retrospective chart review. Participants: A total of 27 consecutive patients with persistent macular edema resistant to standard short-term therapy despite quiescent noninfectious intermediate or posterior uveitis. Methods: Each patient was treated with a DEX 0.7 mg implant. Main Outcome Measures: Primary outcome measure was resolution of macular edema 1 month after injection as measured by decrease in central macular thickness (CMT). Secondary outcome was change in visual acuity 1, 2, and 3 months after injection. Results: A total of 27 eyes of 27 patients were included for analysis. One eye was randomly selected for 6 of these patients who received bilateral DEX implants. There was a statistically significant reduction in mean CMT 1 month after DEX implantation (mean, 278.9 mu m; range, 206-352 mu m) compared with baseline (mean, 478.7 mu m; range, 330-667 mu m) (P < 0.0001). There was a statistically significant improvement in visual acuity at 3 months (logarithm of the minimum angle of resolution [logMAR] 0.41; 20/51) compared with baseline (logMAR 0.60; 20/80) (P = 0.0005). There were no major complications after DEX implantation. Conclusions: The DEX implant resulted in a statistically significant improvement in mean CMT and visual acuity without any serious adverse events. (C) 2014 by the American Academy of Ophthalmology.