Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, People's Republic of China.
Eur Rev Med Pharmacol Sci. 2023 Mar;27(5):1743-1758. doi: 10.26355/eurrev_202303_31535.
Uveitis is a type of ocular inflammatory disease caused by various etiologies, for which corticosteroids are the main treatment. Dexamethasone Intravitreal implant (DEX-I) has been widely used in the treatment of uveitis across the world. Then, new indications and complications appeared. This review aims to summarize the use of DEX-I in uveitis in the past 10 years. We summarized the clinical data (baseline characteristics, efficacy and safety) and discussed controversies by retrospectively analyzing the articles and cases published in PubMed and Web of Science using the terms "Ozurdex", OR "intravitreal dexamethasone implant", AND "uveitis" from 2010 to 2022. DEX-I is effective in reducing edema, improving inflammation and improving vision when treating various conditions of uveitis including infectious, no-infectious, pediatric uveitis, and surgery-related applications. The efficacy of DEX-I as a monotherapy is related to the following: etiology and course of disease, treatment of systemic diseases, patients' toleration after multiple injections, economic situation, etc. In addition, intravitreal corticosteroids implantation may replace systemic therapy in some patients. In terms of safety, the incidence of high intraocular pressure is about 20.52%, and the incidence of cataract is about 15.51%. DEX-I can effectively treat non-infectious uveitis and some infectious uveitis such as suspected tuberculosis, and its safety is controllable. Further studies are necessary to evaluate the effect of monotherapy and to expand more indications.
葡萄膜炎是一种由多种病因引起的眼部炎症性疾病,其主要治疗方法为皮质类固醇。地塞米松玻璃体内植入剂(DEX-I)已在全球范围内广泛用于葡萄膜炎的治疗。然而,新的适应证和并发症也相继出现。本综述旨在总结过去 10 年 DEX-I 在葡萄膜炎治疗中的应用。我们通过在 PubMed 和 Web of Science 上检索 2010 年至 2022 年以“Ozurdex”“intravitreal dexamethasone implant”和“uveitis”为关键词的文章和病例,回顾性分析并总结了其临床数据(基线特征、疗效和安全性)和争议点。DEX-I 可有效减轻各种葡萄膜炎(包括感染性、非感染性、儿童葡萄膜炎及手术相关)患者的水肿、改善炎症并提高视力。DEX-I 作为单一疗法的疗效与病因和病程、全身疾病的治疗、多次注射后患者的耐受性、经济状况等因素有关。此外,玻璃体内皮质类固醇植入物可能在某些患者中替代全身治疗。在安全性方面,高眼压的发生率约为 20.52%,白内障的发生率约为 15.51%。DEX-I 可有效治疗非感染性葡萄膜炎和一些感染性葡萄膜炎,如疑似结核,且其安全性是可控的。还需要进一步的研究来评估其单药治疗的效果,并扩大更多的适应证。