Dexamethasone intravitreal implant in serpiginous choroiditis

Miserocchi, Elisabetta; Berchicci, Luigi; Iuliano, Lorenzo; Modorati, Giulio; Bandello, Francesco

doi:10.1136/bjophthalmol-2015-307820

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…The dexamethasone 0.7 mg implant has been shown to be effective and safe for the local treatment of chronic cystoid macular edema secondary to non-infectious uveitis in previous studies ( 6 , 13 ). While the dexamethasone implant is primarily administered for the treatment of uveitic macular edema, it is also employed in other rare uveitic occasions, such as birdshot chorioretinopathy ( 14 ), diffuse uveal melanocytic proliferation ( 15 ), serpiginous choroiditis ( 16 ), exudative RD associated with uveal melanoma ( 17 ), punctate inner choroidopathy ( 18 ), autoimmune retinopathy ( 19 ), ampiginous choroidopathy, tubulointerstitial nephritis and uveitis syndrome, sympathetic ophthalmia and IRVAN syndrome ( 20 ). The studies that included at least 50 uveitic cases who received IDI injections ( 1 , 2 , 20-30 ) are summarized in Table VI .…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone intravitreal implant for macular edema and some other rare indications in uveitis

Koksaldi

Kayabaşı

Ayhan

et al. 2023

Med Int

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In the present study, 110 eyes of 81 patients with uveitis who underwent intravitreal dexamethasone implant (IDI) injection and had a follow-up of at least 6 months between January, 2012 and September, 2022, were retrospectively analyzed. A total of 298 IDI injections were administered (mean, 2.71±2.37; range, 1-12). The mean age of the patients was 49.44±16.67 years (range, 15-86 years). The mean follow-up time after the first IDI was 34.31±26.53 months (range, 6-115 months). In total, 77 (95.1%) patients had non-infectious uveitis, while 4 patients (4.9%) received IDI for uveitic macular edema in association with infectious uveitis (1 patient with acute retinal necrosis and 3 patients with systemic tuberculosis). IDI was injected under the umbrella of intravitreal ganciclovir injection in the patient with healed acute retinal necrosis for the associated pseudophakic cystoid macular edema. A total of 6 patients (7.4%) received IDI prior to phacoemulsification surgery to control the possible post-operative macular edema. In addition, 3 patients (3.7%) with Vogt-Koyanagi-Harada disease received bilateral IDI as the systemic therapy could not be administered due to side-effects of the systemic treatment. In total, 1 patient (1.2%) with idiopathic retinal vasculitis, aneurysms and neuroretinitis was treated with IDI injections in both eyes in addition to systemic therapy to reduce the ongoing inflammation. Of note, two eyes (1.8%) received simultaneous single IDI and anti-vascular endothelial growth factor administration for the treatment of unilateral extrafoveal macular neovascularization (one with active serpiginous choroiditis and one with sympathetic ophthalmia). IDI was administered for the treatment of uveitic macular edema in 68 patients (83.9%). Best-corrected visual acuity improved from 0.69±0.64 to 0.60±0.76 logMAR at the final visit (P=0.008). Baseline mean central macular thickness (CMT) was 499.74±229.60 µm (range, 187-1,187 µm) and the mean final CMT was 296.60±152.02 µm (range, 126-848 µm). Intraocular pressure elevation requiring topical antiglaucomatous eye drops occurred in 28 eyes (25.5%). During the follow-up period, bilateral glaucoma surgery was required in 1 patient (1.2%) and 25 of 65 phakic eyes (38.4%) underwent phacoemulsification. Retinal detachment occurred in one eye (0.9%), endophthalmitis in one eye (0.9%), and transient intravitreal hemorrhage occurred in three eyes (2.7%) after the IDI injections. On the whole, the present study demonstrates that although IDI is mostly employed in non-infectious uveitic eyes with macular edema, it can also be administered in cases with systemic therapy intolerance, pseudophakic macular edema prophylaxis, and with great caution, in selected cases involving infectious uveitis and macular edema.

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Section: Discussionmentioning

confidence: 99%

Dexamethasone intravitreal implant for macular edema and some other rare indications in uveitis

Koksaldi

Kayabaşı

Ayhan

et al. 2023

Med Int

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“…But it is only experimented in vitro, and it may have the defect of perforated eye. Compared to the most popular IVT dexamethasone implant (Miserocchi et al, 2016), the CCSDD of the tube allowing the replenishment of the drug, facilitates for the need for a long time therapy. More importantly, although the CCSDD needs surgical implantation to the sub-Tenon's sac, it does not mechanically break the normal structure of the retina, choroids and can be easily removed if severe complication occurs.…”

Section: Discussionmentioning

confidence: 99%

Controllable continuous sub-tenon drug delivery of dexamethasone disodium phosphate to ocular posterior segment in rabbit

Huang¹,

Liu

Yang

et al. 2017

Drug Delivery

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Corticosteroids have been used for treatment of posterior segment eye diseases, but the delivery of drug to the posterior segments is still a problem to resolve. In our study, we explore the feasibility of Sub-tenon's Controllable Continuous Drug Delivery to ocular posterior segment. Controllable continuous sub-tenon drug delivery (CCSDD) system, intravenous injections (IV) and sub-conjunctival injections (SC) were used to deliver dexamethasone disodium phosphate (DEXP) in rabbits, the dexamethasone concentration was measured in the ocular posterior segment tissue by Shimadzu LC-MS 2010 system at different time points in 24 h after first dose injection. Levels of dexamethasone were significantly higher at 12, 24 h in CCSDD than two other approaches, and at 3, 6 h in CCSDD than IV in vitreous body (p50.01); at 6, 12, 24 h in CCSDD than two other approaches, and at 1, 3 h in CCSDD than IV in retinal/ choroidal compound (p50.01); at 3, 6, 12, 24 h in CCSDD than two other approaches, and at 1 h in CCSDD than IV in sclera (p50.05). The AUC 0-24 in CCSDD group is higher than two other groups in all ocular posterior segment tissue. Our results demonstrated that dexamethasone concentration could be sustained moderately higher in the posterior segment by CCSDD than SC and IV, indicating that CCSDD might be a therapeutic alternative to treat a variety of intractable posterior segment diseases.

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“…The systemic treatments include glucocorticoids, alkylating and non-alkylating immunosuppressive agents, and biological therapies or their combinations. Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) are administered [9,[15][16][17][18][19][20]. The goal of treatment is to prevent new episodes of activity and further inflammatory involvement of the retina.…”

Section: Clinical Features Diagnosis and Managementmentioning

confidence: 99%

Clinical features, diagnosis and management of serpiginuos choroiditis

et al. 2022

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Classic serpiginous choroiditis (CSC) is a rare bilateral, multifocal, recurrent inflammatory disease of the choroid and retina observed mainly in young and middle-aged male patients. We present three cases of otherwise healthy men (ages 30, 52, and 54 years) with the diagnosis of CSC based on clinical and multimodal imaging findings. During the observation period, slow progression of the fundus changes was noted in each patient despite various individualized immunosuppressive treatments (corticosteroids, cyclosporin, cyclophosphamide, azathioprine) used. Progressive macular involvement was associated with a significant irreversible bilateral reduction in visual acuity. The aim of the study is to present the clinical features of CSC, possible diagnostic and therapeutic options, and to familiarize the reader with specific clinical cases.

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Dexamethasone intravitreal implant in serpiginous choroiditis

Abstract: Dexamethasone intravitreal implant may be an effective treatment option to control active serpiginous lesions in patients in whom increased systemic corticosteroid therapy is contraindicated.

Cited by 11 publications

References 24 publications

Dexamethasone intravitreal implant for macular edema and some other rare indications in uveitis

Dexamethasone intravitreal implant for macular edema and some other rare indications in uveitis

Controllable continuous sub-tenon drug delivery of dexamethasone disodium phosphate to ocular posterior segment in rabbit

Clinical features, diagnosis and management of serpiginuos choroiditis

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