Intraocular corticosteroids found to be best for treating complications of chronic inflammatory eye condition

Medical Xpress / National Eye Institute / Ophthalmology ^ | June 13, 2023 | Nisha R. Acharya et al

[ConservativeMind]

Repeat treatment with corticosteroid injections improved vision in people with persistent or recurrent uveitis-related macular edema better than two other therapies, according to results from a clinical trial. Compared with methotrexate or ranibizumab intravitreal (in-the-eye) injections, the corticosteroid treatment achieved greater reductions in retinal swelling and was the only therapy in the study that improved vision.

Uveitis is a collection of inflammatory conditions that affect the internal tissues of the eye.

Inflammation in the eye can lead to fluid buildup in the central part of the eye's light-sensing retina, known as the macula, and decrease vision. This fluid buildup, called macular edema, is a complication of uveitis that often persists or recurs over time, despite uveitis treatment.

In this study, researchers compared three treatments for uveitis-related macular edema: an additional intraocular corticosteroid injection, an injection of the anti-vascular endothelial growth factor (anti-VEGF) drug ranibizumab, or an injection of the anti-inflammatory drug methotrexate.

The clinical trial enrolled 194 participants (225 study eyes) with well-controlled uveitis but persistent or recurrent macular edema.

The injection schedules for each group were based on how each treatment is generally used in clinical practice.

After 12 weeks, all three groups showed reductions in retinal swelling. Reduction was greatest in the dexamethasone group compared to the other two (35% reduction for corticosteroid; 20% for ranibizumab; 11% for methotrexate). In addition, only the corticosteroid group showed improvement in vision, nearly five letters—about one row on an eye chart. The corticosteroid group did have more occurrences of mild increases in intraocular pressure, but rises to high levels were infrequent (<10%) in all three groups.

"Intraocular corticosteroid treatment remains the most effective therapy for uveitis-related macular edema," said Nisha Acharya, M.D. "The vision gains in participants who received the corticosteroid treatment were very promising."

[ConservativeMind]

Corticosteroids were the only therapy one the three to improve eyesight, for those with uveitis-related edema.

[ConservativeMind]

The “Take Charge Of Your Health” Ping List
This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20 - 25% fewer pings) or “Everything” list.