Bratton Monica L, He Yu-Guang, Weakley David R
Department of Ophthalmology, University of Texas Southwestern, Dallas, Texas.
Department of Ophthalmology, University of Texas Southwestern, Dallas, Texas.
J AAPOS. 2014 Apr;18(2):110-3. doi: 10.1016/j.jaapos.2013.11.014.
To report our experience using Ozurdex (Allergan, Irvine, CA), a biodegradable intravitreal implant containing of 0.7 mg of dexamethasone approved for use in adults with noninfectious uveitis in adults, in the treatment of pediatric uveitis.
The medical records of consecutive patients with noninfectious posterior uveitis who were unresponsive to standard treatment and subsequently received the Ozurdex implant from March 2011 to March 2013 were retrospectively reviewed.
A total of 14 eyes of 11 patients (mean age, 10.1 years; range 4-12) received 22 Ozurdex implants during the study period. Of the 11 patients, 7 had idiopathic intermediate or posterior uveitis, 1 had sympathetic ophthalmia, 2 had juvenile idiopathic arthritis, and 1 had sarcoidosis. All patients were uncontrolled with standard treatment, including topical or sub-Tenon's or systemic corticosteriods and/or immune-modulation. Visual acuity improved after Ozurdex implant in 5 of 8 patients (63%). Intraocular inflammation was controlled or improved after 17 of 22 of implants (12 eyes [77%]). The frequency of topical corticosteroids was decreased and/or discontinued after 18 of 22 implants (12 eyes [82%]). Complications included implant migration into the anterior chamber (4 aphakic eyes), increased intraocular pressure (5 eyes), and progression of a preexisting cataract (1 eye). The uveitis reoccurred in 57% of eyes at 4.3 months (2-7 months) after injection.
The Ozurdex implant in combination with systemic immunomodulatory therapy resulted in improved visual acuity, control of intraocular inflammation, and a decrease in corticosteroid use. In the majority of eyes the uveitis reoccurred around 4 months after injection. The adverse events in our study are similar to those identified in adult studies.
报告我们使用Ozurdex（爱尔康公司，尔湾，加利福尼亚州）治疗儿童葡萄膜炎的经验，Ozurdex是一种可生物降解的玻璃体内植入物，含有0.7毫克地塞米松，已被批准用于治疗成人非感染性葡萄膜炎。
回顾性分析2011年3月至2013年3月期间连续收治的对标准治疗无反应并随后接受Ozurdex植入物的非感染性后葡萄膜炎患者的病历。
在研究期间，11例患者（平均年龄10.1岁；范围4 - 12岁）的14只眼共接受了22次Ozurdex植入。11例患者中，7例患有特发性中间或后葡萄膜炎，1例患有交感性眼炎，2例患有幼年特发性关节炎，1例患有结节病。所有患者经标准治疗（包括局部或Tenon囊下或全身使用皮质类固醇和/或免疫调节）均未得到控制。8例患者中有5例（63%）在植入Ozurdex后视力得到改善。22次植入中的17次（12只眼[77%]）后眼内炎症得到控制或改善。22次植入中的18次（12只眼[82%]）后局部皮质类固醇的使用频率降低和/或停用。并发症包括植入物移入前房（4只无晶状体眼）、眼压升高（5只眼）和原有白内障进展（1只眼）。注射后4.3个月（2 - 7个月），葡萄膜炎在57%的眼中复发。
Ozurdex植入物联合全身免疫调节治疗可提高视力、控制眼内炎症并减少皮质类固醇的使用。在大多数眼中，葡萄膜炎在注射后约4个月复发。我们研究中的不良事件与成人研究中发现的相似。
