Long-Term Efficacy of Dexamethasone Intravitreal Implant in the Treatment of Vogt-Koyanagi-Harada (VKH) Disease Relapsing Posterior Uveitis

Abstract

Purpose: To investigate the efficacy and safety of dexamethasone intravitreal implant in the treatment of relapsing posterior uveitis in patients with chronic recurrent VKH disease.Methods: This is a prospective study of 29 eyes of 16 patients with posterior uveitis in chronic recurrent VKH disease. All patients received previous systemic steroid and immunosuppressive regimens. All patients underwent a comprehensive ophthalmic examination, including BCVA (log MAR), IOP, FFA, and SD-OCT. All patients underwent intravitreal injection with sustained-release dexamethasone 0.7 mg implant (Ozurdex®). Primary outcome measures included mean change in best corrected visual acuity (BCVA) and central foveal thickness (CFT) at 24 months follow-up compared to baseline. Results: At 24 months follow-up, the mean BCVA improved from 0.82 ± 0.13 to 0.38 ± 0.06logMAR (P <0.0001). The mean CFT reduced from 505 ± 29 to 244 ± 23 um (P <0.0001). The mean IOP changed from 15.1±2.2 to16.9±3.1 mmHg with no significant value. Twenty-one eyes (72.4%) received one injection, while eight eyes (27.6%) required two injections. The mean number of injections was 1.2± 0.60. The mean follow-up time was 24.75± 0.9months. No serious ocular or systemic adverse events were noted during the follow-up period. Ocular hypertension was recorded in there (10.3%) eyes and controlled by IOP lowering medications. Cataract progression occurred in 11 (37.9%) eyes.Conclusions: Our cohort highlights the beneficial effects of the Dexamethasone implant 0.7 mg in the treatment of VKH disease relapsing posterior uveitis improving visual acuity, reducing macular edema, and minimizing the burden of systemic steroid in this sample study.