title: Intravitreal Dexamethasone Implant (Ozurdex) to Control Recurrent Severe Idiopathic Uveitis Leads to Improvement in Steroid-Induced Diabetes Mellitus.
abstract: Steroid-induced diabetes mellitus (SIDM) poses a unique challenge for the physician and ophthalmologist when faced with chronic recurrent uveitis controlled only with systemic steroids. We report a unique case where SIDM improved significantly following administration of intravitreal dexamethasone. A 53-year-old female had a history of recurrent idiopathic anterior uveitis that required oral steroids for control despite orbital floor steroids and systemic immunosuppression. After 9 years of oral steroid treatment she was diagnosed with SIDM necessitating insulin therapy. Following intravitreal dexamethasone implant, her oral steroid use was tapered with subsequent improvement in her diabetes and eventual cessation of insulin. In uveitis, steroid sparing immunosuppression may be used to minimize systemic steroid exposure. In this case, we demonstrated that an intravitreal dexamethasone implant achieved this goal. We recommend considering the use of such implants in patients with recurrent uveitis, particularly when there are significant steroid-induced side effects.
authors.affiliation: a Princess Alexandra Eye Pavilion , Edinburgh , UK.
authors.forename: Ashraf A
authors.initials: AA
authors.lastname: Khan
authors.affiliation: a Princess Alexandra Eye Pavilion , Edinburgh , UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Kontos
authors.affiliation: a Princess Alexandra Eye Pavilion , Edinburgh , UK.
authors.forename: Sheila P
authors.initials: SP
authors.lastname: Paterson-Brown
authors.affiliation: a Princess Alexandra Eye Pavilion , Edinburgh , UK.
authors.forename: Baljean
authors.initials: B
authors.lastname: Dhillon
mesh_terms: D060433:Administration, Ophthalmic; D003907:Dexamethasone / Q000008:administration & dosage*; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000503:physiopathology*; D004343:Drug Implants; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D058449:Intravitreal Injections; D008875:Middle Aged; D012008:Recurrence; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy*; D014792:Visual Acuity
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Insulin; intravitreal dexamethasone; ozurdex; steroid-induced diabetes; uveitis