title: Intravitreal ketorolac for chronic uveitis and macular edema: a pilot study.
abstract: OBJECTIVE
  To investigate the adverse ocular effects of intravitreal ketorolac (4 mg) in patients with chronic uveitis and complications of chronic inflammation (macular edema).
  
  
  METHODS
  We conducted a prospective phase 1 clinical trial involving 10 eyes of 10 adult patients with chronic inflammation and/or macular edema for whom previous treatment failed or who could not tolerate corticosteroids because of adverse ocular effects. Baseline (day 0) electroretinography, fluorescein angiogram, spectral domain optical coherence tomography (OCT), Goldmann visual field, and complete ophthalmic examination were performed, and then a single intravitreal injection of ketorolac (4 mg) was administered. Another ophthalmic examination with OCT was performed on day 3. Ophthalmic examination with fluorescein angiogram and OCT was repeated on days 7 and 30, and ophthalmic examination with fluorescein angiogram, OCT, electroretinography, and Goldmann visual field was performed on day 90. The study took place from March 1, 2010, through February 28, 2011.
  
  
  RESULTS
  On the basis of ophthalmic examination findings, visual field, and electroretinography testing, there were no observed adverse ocular effects of intravitreal ketorolac. In 2 of 2 eyes with active intraocular inflammation, there was early resolution of inflammation, and in 4 of 8 eyes with macular edema, there appeared to be transient reduction in OCT thickness and/or fluorescein angiogram leakage.
  
  
  CONCLUSIONS
  A single intravitreal injection of ketorolac (4 mg) appeared to be well tolerated.
  
  
  CONCLUSIONS
  Intravitreal ketorolac requires further clinical trials to determine whether it is an effective means to treat posterior segment inflammation as a safer alternative to corticosteroids in patients at increased risk of cataract formation and increased intraocular pressure.
authors.affiliation: Department of Ophthalmology, Vanderbilt University School of Medicine, 2311 Pierce Ave, Nashville, TN 37232, USA. skim30@gmail.com
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kim
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Doherty
authors.forename: Edward F
authors.initials: EF
authors.lastname: Cherney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D058449:Intravitreal Injections; D020911:Ketorolac Tromethamine / Q000008:administration & dosage* / Q000009:adverse effects; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012160:Retina / Q000502:physiology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000187:drug effects; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects
chemical_list: D016861:Cyclooxygenase Inhibitors; D020911:Ketorolac Tromethamine