Treatment of Uveitis

Introduction to Treatment Options

The American Academy of Ophthalmology suggests Ozurdex for non-infectious posterior uveitis, with treatment limited to affected eyes, although in some cases, both eyes may show evidence of disease involvement 1
Other guidelines recommend Ozurdex as a treatment option for non-infectious posterior uveitis, with alternative treatments available if Ozurdex is not effective or contraindicated 1

Systemic immunosuppressives such as azathioprine, mycophenolate mofetil, or methotrexate are suggested as alternative treatments if Ozurdex is not effective or contraindicated, as recommended by other guidelines 1
Calcineurin inhibitors like cyclosporine or tacrolimus are also suggested as alternative treatments if Ozurdex is not effective or contraindicated 1
Biologic agents such as adalimumab or infliximab are suggested for refractory cases if Ozurdex is not effective or contraindicated 1

Ozurdex can effectively control inflammation in 77-82% of eyes with non-infectious uveitis, with a therapeutic effect lasting 3-4 months before inflammation may recur 1
Potential side effects of Ozurdex include IOP elevation (16-20% of cases), cataract formation/progression, and implant migration (rare) 1
The American Academy of Ophthalmology recommends dexamethasone intravitreal implant (Ozurdex) for macular edema secondary to retinal vein occlusions, with significant visual acuity gains and reduced central macular thickness, as demonstrated in the GENEVA and COBALT studies 2, 3
Ozurdex 0.7mg injections are recommended every 3-4 months for the treatment of macular edema secondary to central retinal vein occlusion (CRVO), with efficacy diminishing by 6 months 2, 3

Monitoring of intraocular pressure (IOP) is necessary in patients with a history of steroid response, as IOP elevation is a common side effect of Ozurdex treatment, according to the American Academy of Ophthalmology 2, 3
Regular monitoring of visual acuity, IOP, and OCT imaging for macular thickness is necessary to ensure effective treatment and minimize side effects, as recommended by the American Academy of Ophthalmology 2
The presence of an epiretinal membrane may compound macular edema and limit treatment response, highlighting the need for individualized treatment plans, according to the American Academy of Ophthalmology 2

Current guidelines support treatment with Ozurdex only in eyes with active macular edema, and not for prophylactic treatment without active macular edema, as stated by the American Academy of Ophthalmology 2, 3
Less frequent injections compared to anti-VEGF therapy (every 3-4 months vs. monthly) make Ozurdex a convenient treatment option, as recommended by the American Academy of Ophthalmology 2, 3