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Intravitreal fluocinolone acetonide implant (RetisertTM) in the management of severe non‐infectious posterior uveitis.
Author(s) -
CHAKRABARTI M,
UPENDRAN MR,
FRAZER D,
SILVESTRI G
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.4456.x
Subject(s) - medicine , fluocinolone acetonide , uveitis , implant , posterior segment of eyeball , visual acuity , immunosuppression , surgery , trabeculectomy , triamcinolone acetonide , sympathetic ophthalmia , ophthalmology , intraocular pressure
Purpose To report our experience with the intravitreal fluocinolone acetonide implant (Retisert TM) in treating patients with severe chronic non‐infectious posterior uveitis. Methods Retrospective review of case notes of patients with severe posterior uveitis who had Retisert TM implants over a 6‐year period. 12 eyes of 9 patients were identified. Indications for implantation included need for repeated sub‐tenon triamcinolone injections, non‐responsiveness, poor tolerance to systemic medication or unilateral disease. Results The follow‐up time ranged from 9 to 76 months (mean ‐ 35.4). 3 patients received implants in both eyes. In 3 patients who were followed up for longer than 36 months, a second implant was inserted. Snellen visual acuity improved in all eyes, average gain being 3.5 lines (range 1‐6). There was improved control of the intraocular inflammation in all patients. All patients have been able to either stop or reduce systemic immunosuppressant therapy within 6‐ 12 months of the procedure. Six (40%) eyes developed raised IOP with 4 requiring trabeculectomy. Five patients required cataract surgery. One patient developed a peripheral retinal tear with localised detachment, which was treated successfully with vision returning to 6/6. Conclusion RetisertTM is very effective in severe non‐infectious posterior uveitis and may be the ideal option in those intolerant or unresponsive to topical and systemic immunosuppression. It can also be used in bilateral disease. The significant complications are acceleration of cataract and raised IOP. However, these need to be considered against the benefits of better control of inflammation and reduced systemic immunosuppression.