Burkholder et al. reported the practice patterns of 45 respondents of approximately 176 surveyed members of the American Uveitis Society regarding the use of the Ozurdex implant. Most respondents performed the injection in either a procedure (41.0%) or clinic (23.1%) room, with just over one in five (20.5%) preferring an operating room. Over half (57.5%) used subconjunctival lidocaine as their primary anesthetic. The most frequent indication for injection was macular oedema (76.5%), whereas the most commonly associated diagnosis was pars planitis (24.7%), followed by multifocal choroiditis (18.8%), birdshot chorioretinitis (18.8%), and sarcoid associated uveitis (17.6%). The most commonly cited contraindication to injection was aphakia (62.2%) reflecting concern for anterior chamber migration of the implant with subsequent corneal decompensation. Other contraindications were glaucoma requiring more than two pressure lowering medications (54.0%), a history of corticosteroid-induced ocular hypertension (32.4%), and the presence of an anterior chamber intraocular lens (32.4%). Over one-third (37.7%) of respondents were of the opinion that the Ozurdex implant was effective for longer, whereas nearly three-quarters (71.4%) were of the opinion that the Ozurdex implant was less likely to cause corticosteroid induced ocular hypertension when compared with an anchored fluocinolone acetonide (FA) implant. Nearly half of all respondents (46.5%) preferred either a trial with at least one Ozurdex implant prior to placing an anchored FA implant, or using multiple DEX implants in place of an FA implant (48.8%). Nearly two-thirds (64.3%) responded that they did fewer anchored FA implants since the approval of Ozurdex implants. Additional long-term data are needed to better understand the risks and benefits of sequential Ozurdex implants. The authors noted the wide variability in practice patterns and the clearly perceived role for both the Ozurdex and FA implants in treating patients with chronic non-infectious uveitis. 

The dexamethasone intravitreal implant for noninfectious uveitis: practice patterns among uveitis specialists.
Burkholder BM, Moradi A, Thorne JE, Dunn JP.
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Saruban Pasu

Moorfields Eye Hospital, London, UK.

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