Dexamethasone intravitreal implant (Ozurdex) for the treatment of pediatric uveitis.

Abstract

PURPOSE:

To report our experience using Ozurdex (Allergan, Irvine, CA), a biodegradable intravitreal implant containing of 0.7 mg of dexamethasone approved for use in adults with noninfectious uveitis in adults, in the treatment of pediatric uveitis.

METHODS:

The medical records of consecutive patients with noninfectious posterior uveitis who were unresponsive to standard treatment and subsequently received the Ozurdex implant from March 2011 to March 2013 were retrospectively reviewed.

RESULTS:

A total of 14 eyes of 11 patients (mean age, 10.1 years; range 4-12) received 22 Ozurdex implants during the study period. Of the 11 patients, 7 had idiopathic intermediate or posterior uveitis, 1 had sympathetic ophthalmia, 2 had juvenile idiopathic arthritis, and 1 had sarcoidosis. All patients were uncontrolled with standard treatment, including topical or sub-Tenon's or systemic corticosteriods and/or immune-modulation. Visual acuity improved after Ozurdex implant in 5 of 8 patients (63%). Intraocular inflammation was controlled or improved after 17 of 22 of implants (12 eyes [77%]). The frequency of topical corticosteroids was decreased and/or discontinued after 18 of 22 implants (12 eyes [82%]). Complications included implant migration into the anterior chamber (4 aphakic eyes), increased intraocular pressure (5 eyes), and progression of a preexisting cataract (1 eye). The uveitis reoccurred in 57% of eyes at 4.3 months (2-7 months) after injection.

CONCLUSIONS:

The Ozurdex implant in combination with systemic immunomodulatory therapy resulted in improved visual acuity, control of intraocular inflammation, and a decrease in corticosteroid use. In the majority of eyes the uveitis reoccurred around 4 months after injection. The adverse events in our study are similar to those identified in adult studies.

• Authors: Monica L Bratton, Yu-Guang He, David R Weakley
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 18 Issue 2 Pg. 110-3 (Apr 2014) ISSN: 1528-3933 [Electronic] United States
• PMID: 24698604 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

Chemical References

• Drug Implants
• Glucocorticoids
• Dexamethasone

Topics

• Absorbable Implants
• Administration, Topical
• Child
• Child, Preschool
• Dexamethasone (administration & dosage)
• Drug Implants
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Immunomodulation
• Male
• Retrospective Studies
• Treatment Outcome
• Uveitis (drug therapy, physiopathology)
• Vitreous Body (drug effects)