Intravitreal fluocinolone acetonide implant controls posterior uveitis

A fluocinolone acetonide implant seems effective for treating noninfectious posterior uveitis, reported Carlos Pavesio, MD, who reported his results at the American Academy of Ophthalmology.

The advantages of such an implant are that it can form a small device for implantation into the eye because of its low solubility and high potency. In addition, the drug has a short systemic half life, which reduces the risk of systemic exposure of the drug in patients, said Dr. Pavesio, of Moorfields Eye Hospital, London.

In this study, investigators used 0.59 mg of fluocinolone acetonide and compared the results with the standard of care in a randomized, controlled, phase IIb/III multicenter trial. The drug was tapered over 12 weeks after implantation. The standard of care consisted of administration of corticosteroids and immunosuppressants for at least 6 months.

A total of 146 patients were included in the study, and 66 implants were performed.

Dr. Pavesio reported that the 2-year recurrence rate of uveitis was 34.8% in the patients who received implants and 64.9% in those who received standard of care. This difference was significant (p = 0.0004).

There were some complications in the implant group. Cataracts developed in 88% of those implanted with the device, and hypotony developed in 10.6%. The IOP increased requiring a filtering surgery or explantation of the device in 24% of implanted eyes.

Dr. Pavesio reported that the visual acuity increased by at least three lines in 17.2% of patients who received the implant, which was a similar result to the group that received standard of care, but without the need for high-dose systemic steroids. The visual acuity stabilized or improved in most eyes with the implant.

"Two years after implantation, the device provided better control of inflammation and equivalent visual acuity when compared with systemic therapy," Dr. Pavesio concluded.