Ocular immunology and inflammation · 2017
Clinical Outcomes of Adjunctive Sustained-Release Intravitreal Dexamethasone Implants in Tuberculosis-Associated Multifocal Serpigenoid Choroiditis.
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Jain Lubhani, Panda Krushna Gopal, Basu Soumyava
Аннотация
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.
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.
Предметные рубрики MeSH
AdultChoroiditisDelayed-Action PreparationsDexamethasoneDrug ImplantsFemaleFluorescein AngiographyFollow-Up StudiesFundus OculiGlucocorticoidsHumansIntravitreal InjectionsMaleMicroscopy, AcousticMiddle AgedMultifocal ChoroiditisOphthalmoscopyRetrospective StudiesTomography, Optical CoherenceTreatment OutcomeTuberculosis, OcularYoung Adult