title: Outcomes of birdshot chorioretinopathy treated with an intravitreal sustained-release fluocinolone acetonide-containing device.
abstract: OBJECTIVE
  To evaluate outcomes in birdshot chorioretinopathy following intravitreal implantation of a fluocinolone acetonide-containing drug delivery device.
  
  
  METHODS
  Retrospective, multicenter, interventional case study.
  
  
  METHODS
  University- and community-based tertiary care. Twenty-two HLA-A29+ birdshot patients (36 eyes) were implanted with a sustained-release corticosteroid device and followed for up to 3 years. Main outcome measures were Snellen acuity, intraocular inflammation, adjunctive therapy, cataract, ocular hypertension, or glaucoma. Paired Wilcoxon statistics were used to analyze visual acuities; paired McNemar statistics were used to analyze presence or absence of other outcomes.
  
  
  RESULTS
  Nineteen of 22 patients (32 eyes) completed 12 months of follow-up with improvement in median visual acuity (P=.015). Prior to implantation, 18 of 22 patients (82%) received immunosuppressive therapy versus 1 of 19 (5%) by 12 months (P<.001). Eyes with zero vitreous haze increased from 7 of 27 scored eyes (26%) at baseline to 30 of 30 eyes (100%) by 12 months (P<.001). Cystoid macular edema decreased from 13 of 36 eyes (36%) at baseline to 2 of 32 eyes (6%) at 12 months (P=.006). Five of 24 phakic eyes at baseline exited the study before surgery; all other eyes received cataract surgery. One hundred percent of study eyes had ocular hypertension, required intraocular pressure-lowering therapy, or had glaucoma surgery by 12 months.
  
  
  CONCLUSIONS
  Implantation of a fluocinolone acetonide-containing intraocular device in birdshot chorioretinopathy can improve vision, control inflammation, and eliminate systemic therapy. There is a high incidence of cataract progression and intraocular hypertension or glaucoma.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Rush
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldstein
authors.forename: David G
authors.initials: DG
authors.lastname: Callanan
authors.forename: Beeran
authors.initials: B
authors.lastname: Meghpara
authors.forename: William J
authors.initials: WJ
authors.lastname: Feuer
authors.forename: Janet L
authors.initials: JL
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000503:physiopathology; D015862:Choroid Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016503:Drug Delivery Systems; D004343:Drug Implants; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011246:Pregnadienetriols / Q000008:administration & dosage* / Q000009:adverse effects; D012164:Retinal Diseases / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields; D014822:Vitreous Body
chemical_list: D004343:Drug Implants; D011246:Pregnadienetriols; C100065:flucloronide