Outcomes of birdshot chorioretinopathy treated with an intravitreal sustained-release fluocinolone acetonidecontaining device

Ryan B. Rush, Debra A. Goldstein, David G. Callanan, Beeran Meghpara, William J Feuer, Janet L Davis

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To evaluate outcomes in birdshot chorioretinopathy following intravitreal implantation of a fluocinolone acetonidecontaining 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 pressurelowering therapy, or had glaucoma surgery by 12 months. Conclusions Implantation of a fluocinolone acetonidecontaining 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.

Original languageEnglish
Pages (from-to)630-636
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume151
Issue number4
DOIs
StatePublished - Apr 1 2011

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Equipment and Supplies
Glaucoma
Cataract
Ocular Hypertension
Visual Acuity
fluocinolone
Birdshot chorioretinopathy
Inflammation
Macular Edema
Tertiary Healthcare
Therapeutics
Immunosuppressive Agents
Adrenal Cortex Hormones
Outcome Assessment (Health Care)
Hypertension
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Outcomes of birdshot chorioretinopathy treated with an intravitreal sustained-release fluocinolone acetonidecontaining device. / Rush, Ryan B.; Goldstein, Debra A.; Callanan, David G.; Meghpara, Beeran; Feuer, William J; Davis, Janet L.

In: American Journal of Ophthalmology, Vol. 151, No. 4, 01.04.2011, p. 630-636.

Research output: Contribution to journalArticle

Rush, Ryan B. ; Goldstein, Debra A. ; Callanan, David G. ; Meghpara, Beeran ; Feuer, William J ; Davis, Janet L. / Outcomes of birdshot chorioretinopathy treated with an intravitreal sustained-release fluocinolone acetonidecontaining device. In: American Journal of Ophthalmology. 2011 ; Vol. 151, No. 4. pp. 630-636.
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