Treatment of Experimental Anterior and Intermediate Uveitis by a Dexamethasone Intravitreal Implant

Ghosn, Corine; Li, Yong; Orilla, W.; Lin, Ton; Wheeler, Larry; Burke, James A.; Robinson, Michael R.; Whitcup, Scott M.

doi:10.1167/iovs.10-5939

Cited by 41 publications

(33 citation statements)

References 39 publications

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“…Ozurdex was recently approved by the United States Food and Drug Administration and by the European Union and is licensed in all EU countries for the treatment of adult patients with ME following retinal vein occlusion. However, there is evidence for efficacy in multiple clinical situations, including DME, ME associated with uveitis or Irvine-Gass syndrome, DME in vitrectomized eyes, persistent ME, noninfectious vitritis, and as adjunctive therapy for age-related macular degeneration [10,11,12,13,14,15,16,17,18]. …”

Section: Introductionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant in Patients with Persistent Diabetic Macular Edema

et al. 2012

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Purpose: To evaluate the effects of a single injection of Ozurdex over 6 months in eyes with persistent diabetic macular edema (DME). Methods: In this retrospective interventional study, 9 patients with decreased visual acuity, as a result of persistent DME, received Ozurdex (intravitreal dexamethasone implant 0.7 mg). Main outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Results: Nine eyes of 9 patients (5 males, 4 females; mean age 58 years) were included in the analysis. The mean duration of DME was 49.9 months (range 24–85). All patients had undergone previous treatments for DME (intravitreal injection of anti-vascular endothelial growth factor, steroids or laser photocoagulation) before entering the study. At baseline, the mean BCVA was 0.74 ± 0.33 logMAR, and the mean CRT was 502 ± 222.16 µm. The mean BCVA was unchanged on the third day (0.74 ± 0.38 logMAR, p = 0.5), improved to 0.62 ± 0.32 logMAR (p = 0.02), 0.59 ± 0.26 logMAR (p = 0.02) and 0.63 ± 0.38 logMAR (p = 0.6) after the first, third and fourth months, respectively, and decreased again to 0.73 ± 0.35 logMAR (p = 0.4) at 6 months. The mean CRT improved to 397 ± 115.31 µm (p = 0.17), 271 ± 99.97 µm (p = 0.007), 325 ± 133.05 µm (p = 0.03) and 462 ± 176.48 µm (p = 0.36) on the third day and after 1, 3 and 4 months of follow-up and then increased again to 537 ± 265.42 µm (p = 0.33) at 6 months. Eight patients needed retreatments in the sixth month. One eye developed a transient intraocular pressure (IOP) increase 1 month after injection, which was successfully managed with topical IOP-lowering medication. Conclusion: In eyes with persistent DME, Ozurdex produces improvement in BCVA and CRT as soon as the first days after the injection. Such improvement is maintained until the fourth month.

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Section: Introductionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant in Patients with Persistent Diabetic Macular Edema

et al. 2012

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“…In an effort to avoid the side effects associated with systemic steroids, sustained-release intraocular corticosteroid implants have been developed [9,10]. The dexamethasone drug delivery system (Ozurdex®; Allergan Inc., Irvine, Calif., USA) is a biodegradable intravitreal implant with potent anti-inflammatory properties, and a favorable side effect profile.…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone Intravitreal Implant: An Effective Adjunctive Treatment for Recalcitrant Noninfectious Uveitis

Miserocchi¹,

Modorati²,

Pastore³

et al. 2012

Ophthalmologica

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Purpose: To describe our experience in treating recalcitrant and severe cases of noninfectious posterior uveitis with the 0.7-mg dexamethasone intravitreal implant as adjunctive anti-inflammatory treatment. Procedures: Retrospective study. Twelve patients (8 females; 4 males; 14 affected eyes, 15 implants) with severe recalcitrant uveitis were treated. Patients had an inadequate control of uveitis despite different immunosuppressants and periocular corticosteroid therapy. Primary outcome measures evaluated were: decrease in uveitis activity, improvement in visual acuity, reduction of macular thickness, and occurrence of adverse events. Results: Uveitis activity decreased in all patients after the implant. The mean follow-up time from injection was 9 months. Best-corrected visual acuity improved from 20/80 to 20/40 at the end of follow-up. The mean retinal thickness improved from 496 to 226 µm. Adverse events encountered were: 3 eyes with intraocular pressure elevation, 1 vitreous hemorrhage and 1 subconjunctival hemorrhage. Three patients reduced the daily systemic corticosteroid dosage after treatment. Conclusions: The 0.7-mgdexamethasone intravitreal implant appears to be a novel and promising adjunctive treatment for patients with severe posterior noninfectious uveitis recalcitrant to different immunosuppressive agents.

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“…Recent studies have demonstrated that DEX is routinely prescribed to reduce cerebral oedema and is used increasingly as an anti-emetic (3). It has been reported that nausea, fatigue, and pain scores were all reduced using DEX treatment (4), and a single administration of a DEX implant significantly reduced inflammation in an animal model (5). DEX pretreatment arterializes venous endothelial cells by inducing MAP kinase phosphatase-1 and may protect the veins from inflammation (6).…”

Section: Introductionmentioning

confidence: 99%

Elevated enolase and caveolin-1 in the heart of rats following dexamethasone-induced toxicity

Huang

Liu

2012

Mol Med Report

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Abstract. Dexamethasone (DEX)-induced heart damage is associated with enzyme and protein alterations. The purpose of this study was to investigate DEX-induced alterations in cardiac enolase and caveolin-1 (cav-1) following DEX administration. Male Wistar rats were randomly divided into two groups: a control and a DEX. The DEX group intraperitoneally received DEX at the single dose of 10 mg/kg for 7 consecutive days, and the control was given the same amount of saline via the same route. On day 8, the rats were anesthetized, and a thoracotomy was performed in all animals. Immunohistochemical analysis was performed to evaluate protein expression of enolase and cav-1. Sections were analyzed by digital image analysis. Our results demonstrated that cardiac protein expression of enolase and cav-1 was altered following DEX-induced toxicity in the rat. The expression of enolase and cav-1 was significantly increased after DEX treatment, supported by integrated optical density compared with the control (P<0.05). In conclusion, following DEX-induced toxicity, protein expression of enolase and cav-1 was significantly elevated. The current findings indicate that such alterations would be reflected in abnormal cardiac function, and the proteins identified in this study may be useful in revealing the mechanisms underlying DEX-induced toxicity and also in providing various clues for further research.

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Treatment of Experimental Anterior and Intermediate Uveitis by a Dexamethasone Intravitreal Implant

Abstract: A single administration of DEX implant significantly reduced inflammation in an animal model of anterior and intermediate uveitis.

Cited by 41 publications

References 39 publications

Intravitreal Dexamethasone Implant in Patients with Persistent Diabetic Macular Edema

Intravitreal Dexamethasone Implant in Patients with Persistent Diabetic Macular Edema

Dexamethasone Intravitreal Implant: An Effective Adjunctive Treatment for Recalcitrant Noninfectious Uveitis

Elevated enolase and caveolin-1 in the heart of rats following dexamethasone-induced toxicity

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