Fluocinolone Acetonide Implant Could Be Effective for Noninfectious Uveitis

Amit K. Reddy, MD

Credit: University of Colorado

New retrospective findings indicate the use of 0.18-mg fluocinolone acetonide implant appeared effective in managing noninfectious uveitis affecting the posterior segment, with relatively low rates of ocular hypertension requiring intervention.¹

In analysis, investigators from the University of Colorado Sue Anschutz-Rodgers Eye Center found the use of short-acting corticosteroid injections before placement of the implant does not seem to improve its effectiveness, though they cite selection bias as partial blame.

“Additional studies are required to determine patients who are the optimal candidates for this therapy,” wrote investigators.

Led by Amit K. Reddy, MD, the retrospective cohort study included participants who received the 0.18-mg implant for the treatment of noninfectious uveitis affecting the posterior segment between July 2019 and August 2021 at the investigator’s center. The team excluded patients if they did not have ≥6 months of follow-up after the placement of the implant.

From medical charts, Reddy and colleagues collected data, including age, race and ethnicity, uveitis diagnosis, history, and current use of anti-inflammatory therapy, use of short-acting corticosteroid injections within the 3 months before implantation, visual acuity, intraocular pressure (IOP), grading of the anterior chamber and vitreous cell, and presence of cystoid macular edema. The study defined uveitis recurrence as any increased inflammation that required additional anti-inflammatory therapy.

The main outcome measures for the study were the probability of remaining recurrence-free after the placement of the 0.18-mg fluocinolone acetonide implant. A total of 64 eyes from 42 patients were included in the study.

Results suggest the overall probability of remaining recurrence-free was 68.8% at 6 months and 52.6% at the 12-month follow-up. Data showed eyes that remained recurrence-free at 12 months had a younger mean age than eyes that had a recurrence within 12 months (P = .02).

Moreover, eyes that received a short-acting corticosteroid injection before the 0.18-mg fluocinolone acetonide implant were more likely to have a recurrence by 6 months of follow-up than eyes that did not receive a corticosteroid injection prior to implantation (P = .05). Data showed the initiation or addition of IOP-lowering eyedrops was required in 15.6% of eyes and 4.7% of eyes required IOP-lowering surgery after placement of the 0.18-mg fluocinolone acetonide implant.

References

1. Reddy AK, Pecen PE, Patnaik JL, Palestine AG. Single Institution experience of Intravitreal 0.18-Mg fluocinolone acetonide implant for noninfectious uveitis. Ophthalmology Retina. 2023;7(1):67-71. doi:10.1016/j.oret.2022.07.002