title: Sustained-release dexamethasone intravitreal implant in juvenile idiopathic arthritis-related uveitis.
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.
authors.affiliation: Cole Eye Institute, Cleveland Clinic, E 105th st, 9500 Euclid Avenue, Cleveland, OH, 44106, USA. ilmiticopicchio@gmail.com.|San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, Milan, Italy. ilmiticopicchio@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pichi
authors.affiliation: San Giuseppe Hospital, University Eye Clinic, Via San Vittore 12, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Nucci
authors.affiliation: Cole Eye Institute, Cleveland Clinic, E 105th st, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Baynes
authors.affiliation: Cole Eye Institute, Cleveland Clinic, E 105th st, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Careen Y
authors.initials: CY
authors.lastname: Lowder
authors.affiliation: Cole Eye Institute, Cleveland Clinic, E 105th st, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Srivastava
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D002648:Child; D003692:Delayed-Action Preparations; 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; D008297:Male; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Cystoid macular edema; Dexamethasone intravitreal implant; Juvenile idiopathic arthritis-associated uveitis