One of the many challenges in managing patients with uveitis is the side effects due to the long term use of oral steroids or immunosuppressive drugs. In purely ocular inflammatory disease without any systemic involvement, steroid delivery to the eye would be sufficient. Unfortunately eyedrops alone are unable to reach the back of the eye and treat the sight threatening conditions such as swelling of the macula in uveitis and oral steroids or intraocular steroid injections are often necessary.
A new treatment for uveitis
In the past triamcinolone acetonide was the most commonly used intravitreal corticosteroid for treatment of uveitis and macular oedema. The drug is available at low cost but it is associated with a high risk of raised intraocular pressure (IOP) and cataract .Since steroids are a mainstay of therapy for uveitis and macular edema, new intravitreal implants have been developed to provide continuous release of corticosteroids over prolonged spans of time with reduced systemic adverse effects. My experience lies in the use of Ozurdex, a new biodegradable steroid implant that has a better safety profile and less of these side effects and a longer duration of action. It has been developed for use as treatment of non infectious uveitis and macula edema due to central retinal vein occlusion. Ozurdex is a biodegradable implant containing the corticosteroid dexamethasone. A biodegradable implant is one that doesn’t need to be removed after it releases medication. These implants are injected into the eye under local anaesthesia. It is a simple minor procedure and is painless. It is released as a tiny rod-shaped implant. Inside the eye, the implant is slowly dissolved in the vitreous gel that fills the eye, releasing dexamethasone. The effects of these medications may last up to 6 months.
Many patients who have received ozurdex for uveitis were able to reduce or stop their oral steroids and other immunosuppressive drugs and still achieve good control of uveitis with improvement in vision.