Implant appears effective for treating inflammatory disease within the eye

Jan 10, 2011

An implant that releases the medication dexamethasone within the eye appears safe and effective for the treatment of some types of uveitis (swelling and inflammation in the eye's middle layer), according to a report posted online today that will appear in the May print issue of Archives of Ophthalmology.

"Uveitis refers to a group of intraocular that cause 10 percent to 15 percent of in the developed world," the authors write as background information in the article. "Despite advances in immunosuppressive treatments, corticosteroids remain the mainstay of therapy." However, some patients cannot tolerate or do not respond to systemic corticosteroids, in part because the medications do not cross the blood-retinal barrier. Eye drops containing corticosteroids are effective only for anterior uveitis, closer to the front of the eye. Injections of corticosteroids directly into the eye have been effective in forms of intermediate or posterior uveitis, but require repeated treatments every two to three months and are associated with cataracts and other adverse effects.

To address these issues, an intravitreal (within the vitreous fluid of the eye), bioerodible, sustained-release implant has been developed to deliver a glucocorticoid medication, dexamethasone, to the back of the eye chamber. Careen Lowder, M.D., Ph.D., of the Cleveland Clinic Cole Eye Institute, and colleagues in the Ozurdex HURON Study Group conducted a 26-week randomized controlled trial involving 229 patients with intermediate or posterior uveitis. A total of 77 patients received an implant with a 0.7-milligram dose of dexamethasone, 76 received an implant with a 0.35-milligram dose and 76 underwent a sham procedure which followed the same protocol but used a needleless applicator.

After eight weeks, the eyes were evaluated for the presence and degree of vitreous haze, or that obscures visualization. Vitreous haze was scored from zero to four, with zero indicating no inflammation and four indicating the most severe inflammation, obscuring the optic nerve. At the beginning of treatment, participants had an average vitreous haze score of two.

At the eight-week follow-up, a vitreous haze score of zero was observed in 47 percent of eyes with the 0.7-milligram implant, 36 percent of those with the 0.35-milligram implant and 12 percent of those who underwent the sham procedure. There was no significant difference between the two treatment doses, and the benefit associated with the implant persisted through the 26-week study.

In addition, the percentage of eyes that achieved at least a 15-letter improvement in visual acuity was two- to six-fold greater in both implant groups than in the control group throughout the study.

"Typically, the most common adverse events associated with intravitreal corticosteroids, which may have impacted use in the past, including increases in intraocular pressure [pressure within the eye] and cataract. On any given follow-up visit in the present study, substantial increases in intraocular pressure (to 25 millimeters of mercury or greater) occurred in less than 10 percent of treated eyes," the authors write. In addition, only one of 62 phakic (with lenses) eyes required surgery to remove a cataract.

"In conclusion, the present study demonstrated that in patients with non-infectious intermediate or posterior uveitis, a single dose of the dexamethasone intravitreal implant was well tolerated and produced significant improvements in intraocular inflammation and visual acuity that persisted for six months," the authors conclude. "Overall, the 0.7-milligram dexamethasone intravitreal implant demonstrated greater efficacy than the 0.35-milligram intravitreal , with similar safety."

Explore further: Recorded Ebola deaths top 7,000

More information: Arch Ophthalmol. Published online January 10, 2011. doi:10.1001/archophthalmol.2010.339

add to favorites email to friend print save as pdf

Related Stories

Steroid injections may slow diabetes-related eye disease

Dec 15, 2009

Injecting the corticosteroid triamcinolone into the eye may slow the progression of diabetic retinopathy, a complication of diabetes that can cause vision loss and blindness, according to a report in the December issue of ...

Melatonin may save eyesight in inflammatory disease

Nov 23, 2008

Current research suggests that melatonin therapy may help treat uveitis, a common inflammatory eye disease. The related report by Sande et al., "Therapeutic Effect of Melatonin in Experimental Uveitis," appears in the December ...

Pressure sensors in the eye

Sep 03, 2007

Sensors can monitor production processes, unmask tiny cracks in aircraft hulls, and determine the amount of laundry in a washing machine. In future, they will also be used in the human body and raise the alarm ...

Recommended for you

Recorded Ebola deaths top 7,000

6 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

11 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.