Document Detail


Outcomes of birdshot chorioretinopathy treated with an intravitreal sustained-release fluocinolone acetonide-containing device.
MedLine Citation:
PMID:  21277557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate outcomes in birdshot chorioretinopathy following intravitreal implantation of a fluocinolone acetonide-containing drug delivery device.
DESIGN: Retrospective, multicenter, interventional case study.
METHODS: University- and community-based tertiary care. Twenty-two HLA-A29+ birdshot patients (36 eyes) were implanted with a sustained-release corticosteroid device and followed for up to 3 years. Main outcome measures were Snellen acuity, intraocular inflammation, adjunctive therapy, cataract, ocular hypertension, or glaucoma. Paired Wilcoxon statistics were used to analyze visual acuities; paired McNemar statistics were used to analyze presence or absence of other outcomes.
RESULTS: Nineteen of 22 patients (32 eyes) completed 12 months of follow-up with improvement in median visual acuity (P=.015). Prior to implantation, 18 of 22 patients (82%) received immunosuppressive therapy versus 1 of 19 (5%) by 12 months (P<.001). Eyes with zero vitreous haze increased from 7 of 27 scored eyes (26%) at baseline to 30 of 30 eyes (100%) by 12 months (P<.001). Cystoid macular edema decreased from 13 of 36 eyes (36%) at baseline to 2 of 32 eyes (6%) at 12 months (P=.006). Five of 24 phakic eyes at baseline exited the study before surgery; all other eyes received cataract surgery. One hundred percent of study eyes had ocular hypertension, required intraocular pressure-lowering therapy, or had glaucoma surgery by 12 months.
CONCLUSIONS: Implantation of a fluocinolone acetonide-containing intraocular device in birdshot chorioretinopathy can improve vision, control inflammation, and eliminate systemic therapy. There is a high incidence of cataract progression and intraocular hypertension or glaucoma.
Authors:
Ryan B Rush; Debra A Goldstein; David G Callanan; Beeran Meghpara; William J Feuer; Janet L Davis
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-01
Journal Detail:
Title:  American journal of ophthalmology     Volume:  151     ISSN:  1879-1891     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  2011-05-06     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  630-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cataract / physiopathology
Choroid Diseases / drug therapy*,  physiopathology
Drug Delivery Systems*
Drug Implants
Electroretinography
Female
Fluorescein Angiography
Humans
Male
Middle Aged
Pregnadienetriols / administration & dosage*,  adverse effects
Retinal Diseases / drug therapy*,  physiopathology
Retrospective Studies
Treatment Outcome
Visual Acuity / physiology
Visual Fields
Vitreous Body
Grant Support
ID/Acronym/Agency:
P30 EY001792/EY/NEI NIH HHS; P30 EY001792/EY/NEI NIH HHS; P30 EY001792-33/EY/NEI NIH HHS; P30 EY014801/EY/NEI NIH HHS; P30 EY014801/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Drug Implants; 0/Pregnadienetriols; 3693-39-8/flucloronide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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