Clinical Outcomes of Adjunctive Sustained-Release Intravitreal Dexamethasone Implants in Tuberculosis-Associated Multifocal Serpigenoid Choroiditis.

Abstract

PURPOSE:

To analyze the safety and efficacy of sustained-release intravitreal dexamethasone implant (Ozurdex) in management of TB-associated multifocal serpiginoid choroiditis (MSC).

METHODS:

Retrospective review of TB-associated MSC patients, treated with anti-TB therapy (ATT) and adjunctive intravitreal Ozurdex.

RESULTS:

Nine eyes of six patients were included. Four patients required Ozurdex implant for progressive or new lesions following ATT and two for additional systemic contraindications to corticosteroids - hyperglycemia and uncontrolled hypertension, respectively. The mean time to resolution was 9.17 ± 7.71 weeks. The mean follow-up post-injection was 13.11 ± 6.05 months (median 12 months [range 6-24.5 months]). Only one of nine eyes developed recurrent MSC lesions and this was attributed to possible autoimmune etiology. Two eyes (22.2%) developed steroid-induced glaucoma - one required implant removal.

CONCLUSIONS:

Sustained-release intravitreal dexamethasone is a safe and efficacious adjunctive anti-inflammatory therapy for TB-associated MSC patients with contraindication for systemic corticosteroids or requiring supplemental anti-inflammatory therapy.

• Authors: Lubhani Jain, Krushna Gopal Panda, Soumyava Basu
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 26 Issue 6 Pg. 877-883 ( 2018) ISSN: 1744-5078 [Electronic] England
• PMID: 29020496 (Publication Type: Journal Article)

Chemical References

• Delayed-Action Preparations
• Drug Implants
• Glucocorticoids
• Dexamethasone

Topics

• Adult
• Choroiditis (diagnosis, drug therapy, etiology)
• Delayed-Action Preparations
• Dexamethasone (administration & dosage)
• Drug Implants
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fundus Oculi
• Glucocorticoids (administration & dosage)
• Humans
• Intravitreal Injections
• Male
• Microscopy, Acoustic
• Middle Aged
• Multifocal Choroiditis
• Ophthalmoscopy
• Retrospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Tuberculosis, Ocular (complications)
• Young Adult