title: Intravitreal Dexamethasone Implant for the Treatment of Macular Edema in Chronic Non-infectious Uveitis.
abstract: OBJECTIVE
  To report observations on the single and repeat use of the dexamethasone (DEX) intravitreal implant (Ozurdex; Allergan, Inc, Irvine, CA) for the treatment of macular edema in patients with non-infectious posterior segment uveitis.
  
  
  METHODS
  A chart review of 15 consecutive patients (25 eyes) was conducted. The primary outcome measure of the first and subsequent implants was central retinal thickness (CRT) on spectral-domain optical coherence tomography (sdOCT). Secondary outcomes were best-corrected visual acuity (BCVA), time to repeat implant, and adverse events. Multilevel mixed-effects linear regression was used to determine the effect of the DEX implant compared with baseline. The Kaplan-Meier estimator was used to examine survival from relapse.
  
  
  RESULTS
  A total of 35 implants on 25 eyes of 15 patients were included in the analysis. Of these, 91.4% (32 of 35 eyes) had a reduction in CRT and 80% (20 of 25 eyes) had improved BCVA. After the first DEX implant, CRT decreased from 590 µm (SE: 28 µm) at baseline to 370 µm (SE: 31 µm) at 3 months (p < 0.001). The logMAR VA was 0.614 (SE: 0.089) at baseline and improved to 0.35 (SE: 0.10, p = 0.002), reaching a statistically significant difference at 3 months. A repeat implant led to VA improvement of -0.184 logMAR (SE: 0.171 logMAR) and CRT reduction of -291 µm (SE: 74 µm). There was no significant difference in effect between the first repeat implant and the initial implant. Kaplan-Meier estimates of treatment success were 72% between 3 and 6 months.
  
  
  CONCLUSIONS
  The DEX implant is an effective adjunct treatment to systemic corticosteroid or immunomodulatory therapy. Additional research is required to determine the efficacy of DEX implant as monotherapy for controlling chronic uveitic macular edema.
authors.affiliation: a Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.|b Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Tsang
authors.affiliation: c Department of Ophthalmology , University of Florence , Florence , Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Virgili
authors.affiliation: a Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.|d University of Ottawa Eye Institute , Ottawa , Ontario , Canada.
authors.forename: Maryam
authors.initials: M
authors.lastname: Abtahi
authors.affiliation: a Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.|b Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada.|d University of Ottawa Eye Institute , Ottawa , Ontario , Canada.
authors.forename: Chloe C
authors.initials: CC
authors.lastname: Gottlieb
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012160:Retina / Q000473:pathology; D019233:Retreatment; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D015866:Uveitis, Posterior / Q000188:drug therapy* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Dexamethasone; macular edema; uveitis