Evaluation of fluocinolone acetonide in the management of BRC
Reviewed by Jonathan Chan

This is a single-centre, retrospective, intervention study of 15 eyes of birdshot retinochoroiditis (BRC) patients who received Iluvein, with a mean follow-up period of 31 months. Five eyes had previously received dexamethasone intravitreal implant 0.7mg (Ozurdex). Fluorescein angiography (FA) showed evidence of vascular leakage in all eyes at baseline. 73.4% of eyes had no leakage between six and 12 months, and leakage improved to 84.6% by 24 months. Three eyes had cystoid macular oedema (CMO) at baseline, but all eyes achieved complete resolution of CMO, six months post Iluvein insertion. Persistent hypofluorescent lesions on indocyanine green angiography (ICGA) were unchanged after one year of Iluvein insertion in all cases. Baseline electroretinography (ERG) showed a high incidence of peripheral cone dysfunction and macular dysfunction on pattern ERG (pERG). ERG and pERG improved or stabilised in most patients post treatment. However, persistent choroidal lesions remained with no response to this treatment. The authors suggested that BRC patients require systemic corticosteroids or conventional immunomodulatory therapy to fully control the disease and local intravitreal steroid therapy is insufficient to produce control of choroid inflammation.

Evaluation of fluocinolone acetonide (Iluvien) 0.19mg intravitreal implement in the management of birdshot retinochoroiditis (BRC).
Ajamil-Rodanes S, Testi I, Luis J, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2022;106:234-40.