Abstract:In January 2013, a 54-year-old pseudophakic woman was referred to the ocular inflammation clinic with a diagnosis of panuveitis, already on oral cyclosporine (100 mg/day) since 2010. She was a monocular patient, with the left eye eviscerated due to trauma and secondary endophthalmitis in 1995. She had experienced similar recurring episodes between 2010 and 2013. Examination revealed best-corrected visual acuity (BCVA) of 20/200. The anterior segment revealed the presence of flare and absence of cells. Intraocu… Show more
“…Therefore, although the FAc implant does not appear to be a curative treatment (though possibly the disease burns itself out in some patients), it offers excellent disease control and can prevent recurrences of inflammation over considerable periods of time. Indeed, the authors of a case report describing a patient with panuveitis who demonstrated sustained control of inflammation and macular oedema for at least 3 years after treatment with the FAc implant concluded that the “benefits may persist even after cessation of the direct anti-inflammatory effect of the implant” [ 8 ]. Fig.…”
Background
The current article is a short review of an Alimera Sciences-sponsored symposium held during The 15th International Ocular Inflammation Society Congress in Taiwan on the 14th November 2019 entitled, ‘Preventing relapse of non-infectious uveitis effecting the posterior segment of the eye – evaluating the 0.2 μg/day fluocinolone acetonide intravitreal implant.’
Main text
The fluocinolone acetonide intravitreal implant was approved in Europe for the prevention of relapse in recurrent non-infectious uveitis affecting the posterior segment of the eye and offers a systemic therapy-sparing treatment option by providing low daily dose of corticosteroid into the vitreous for up to 3 years. In the symposium, the presenters reported clinical outcomes from patients with non-infectious uveitis effecting the posterior segment of the eye to support the effectiveness and safety of the implant for up to 3 years in both randomised controlled trials and real-world practices.
Conclusions
Data showed that over a 36 month period, treatment with the fluocinolone acetonide intravitreal implant was associated with significantly fewer episodes of uveitic recurrence, a significantly longer time to uveitic recurrence, greater improvement in visual acuity, a lower need for adjunctive therapy, and an acceptable safety profile.
“…Therefore, although the FAc implant does not appear to be a curative treatment (though possibly the disease burns itself out in some patients), it offers excellent disease control and can prevent recurrences of inflammation over considerable periods of time. Indeed, the authors of a case report describing a patient with panuveitis who demonstrated sustained control of inflammation and macular oedema for at least 3 years after treatment with the FAc implant concluded that the “benefits may persist even after cessation of the direct anti-inflammatory effect of the implant” [ 8 ]. Fig.…”
Background
The current article is a short review of an Alimera Sciences-sponsored symposium held during The 15th International Ocular Inflammation Society Congress in Taiwan on the 14th November 2019 entitled, ‘Preventing relapse of non-infectious uveitis effecting the posterior segment of the eye – evaluating the 0.2 μg/day fluocinolone acetonide intravitreal implant.’
Main text
The fluocinolone acetonide intravitreal implant was approved in Europe for the prevention of relapse in recurrent non-infectious uveitis affecting the posterior segment of the eye and offers a systemic therapy-sparing treatment option by providing low daily dose of corticosteroid into the vitreous for up to 3 years. In the symposium, the presenters reported clinical outcomes from patients with non-infectious uveitis effecting the posterior segment of the eye to support the effectiveness and safety of the implant for up to 3 years in both randomised controlled trials and real-world practices.
Conclusions
Data showed that over a 36 month period, treatment with the fluocinolone acetonide intravitreal implant was associated with significantly fewer episodes of uveitic recurrence, a significantly longer time to uveitic recurrence, greater improvement in visual acuity, a lower need for adjunctive therapy, and an acceptable safety profile.
“…PVOH has been used in many clinically approved products over the last few decades. For example, the Iluvien ® implant has been fabricated by using PVOH and silicone and used for macular edema [ 92 ]. In addition, PVOH has been found to be extensively applied in preclinical research for developing hydrogels, microspheres, and nanoparticles for various therapeutic purposes [ 86 ].…”
The success of long-acting (LA) drug delivery systems (DDSs) is linked to their biocompatible polymers. These are used for extended therapeutic release. For treatment or prevention of human immune deficiency virus type one (HIV-1) infection, LA DDSs hold promise for improved regimen adherence and reduced toxicities. Current examples include Cabenuva, Apretude, and Sunlenca. Each is safe and effective. Alternative promising DDSs include implants, prodrugs, vaginal rings, and microarray patches. Each can further meet patients’ needs. We posit that the physicochemical properties of the formulation chemical design can optimize drug release profiles. We posit that the strategic design of LA DDS polymers will further improve controlled drug release to simplify dosing schedules and improve regimen adherence.
“…Meira et al . [ 71 ] used the dexamethasone implant in a 54-year-old monocular patient with pseudophakia with sympathetic ophthalmia, undergoing therapy with cyclosporine. Because the patient had recurrent cystoid macular edema, supplementation with a dexamethasone implant was performed.…”
Section: Management Of Sympathetic Ophthalmiamentioning
Sympathetic ophthalmia is a rare, bilateral, granulomatous, panuveitis following penetrating trauma or surgery to one eye. Clinical presentation commonly occurs within the first year of trauma occurrence but can be delayed by several years. It manifests as acute/chronic granulomatous uveitis with yellowish-white choroidal lesions or Dalen–Fuchs nodules. Initially, patients respond rapidly to corticosteroid therapy, but a majority require long-term use of corticosteroid-sparing agents to prevent recurrences. The purpose of this review is to elaborate on the current understanding of the pathophysiology, the importance of multimodal imaging in early diagnosis, and the role of newer immunomodulatory and biological agents in recalcitrant cases.
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