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Sustained-release dexamethasone intravitreal implant in juvenile idiopathic arthritis-related uveitis

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Abstract

The purpose of this study is to review the results of treatment of juvenile idiopathic arthritis-related uveitis with the use of intravitreal dexamethasone implant. Sixteen eyes with Juvenile idiopathic arthritis (JIA)-associated uveitis received intravitreal dexamethasone implant to treat recalcitrant anterior segment inflammation (43.7 %), chronic macular edema (6.2 %), or a combination of both (50 %). One month after injection, mean visual acuity had improvement to 39.6 ± 11 ETDRS letters (p < 0.001). Mean AC cells measure at 1 month was 0.79 and 0.75 at 3 months. One month after injection, there was a significant reduction of central retinal thickness (CRT) to 342.4 ± 79.3 µm (p < 0.01). One month after the second implant, 11 eyes (91.6 %) achieved improved activity of the anterior uveitis, and mean best-corrected visual acuity improved to 44.6 ± 8.1 ETDRS letters (p < 0.01). At 1 month after the second injection, 4/5 eyes had resolution of macular edema with CRT of 250.4 ± 13.7 µm (p < 0.01). Of the 16 eyes, 12 eyes received a second injection at mean of 7.5 ± 3.1 months after the first treatment, and 5 eyes received a third Ozurdex injection on average 7 ± 4.6 months after the second injection. Of the 16 eyes, five eyes were pseudophakic prior to injection. Of the remaining 11 eyes, 8 (73 %) developed worsening posterior subcapsular cataract at a mean of 7.3 ± 1.2 months after the first injection. After the first injection, only one eye required topical antiglaucoma therapy with maximum pressure of 25 mmHg. In patients with recalcitrant JIA-associated active uveitis, injection of sustained-release dexamethasone can achieve control of anterior inflammation and resolution of macular edema.

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Authors and Affiliations

  1. Cole Eye Institute, Cleveland Clinic, E 105th st, 9500 Euclid Avenue, Cleveland, OH, 44106, USA

    Francesco Pichi, Kimberly Baynes, Careen Y. Lowder & Sunil K. Srivastava

  2. San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, Milan, Italy

    Francesco Pichi & Paolo Nucci

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  1. Francesco Pichi
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  2. Paolo Nucci
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  3. Kimberly Baynes
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  4. Careen Y. Lowder
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  5. Sunil K. Srivastava
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Correspondence to Francesco Pichi.

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Pichi, F., Nucci, P., Baynes, K. et al. Sustained-release dexamethasone intravitreal implant in juvenile idiopathic arthritis-related uveitis. Int Ophthalmol 37, 221–228 (2017). https://doi.org/10.1007/s10792-016-0265-9

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  • DOI: https://doi.org/10.1007/s10792-016-0265-9

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