J Fr Ophtalmol. 2026 Jun 24;49(7):104935. doi: 10.1016/j.jfo.2026.104935. Online ahead of print.
ABSTRACT
PURPOSE: Macular edema is a significant cause of vision loss in uveitis. Effective control of underlying inflammation is essential to treating macular edema in non-infectious uveitis, typically with corticosteroids. In this study, we examine the use of sequential dexamethasone and fluocinolone acetonide steroid intravitreal implants to promote rapid improvement and sustained control in non-infectious uveitic macular edema.
METHODS: Sixteen eyes from eleven patients with recurrent uveitic macular edema who received sequential intravitreal dexamethasone and fluocinolone acetonide implants were studied via retrospective chart review in 3-month intervals over a 24-month observation window. All patients had received at least one prior dexamethasone implant, which was used both therapeutically and to assess the intraocular-pressure response to an intravitreal corticosteroid before proceeding to the fluocinolone acetonide implant. The primary outcome was the recurrence rate of clinically significant macular edema after treatment. Chart review was performed to identify recurrences and need for additional anti-inflammatory treatment. We also evaluated change in visual acuity, intraocular pressure, and central subfield thickness throughout the study duration.
RESULTS: Twelve eyes (75%) did not experience a recurrence in clinically significant macular edema after treatment with both intravitreal injections. The rate of retreatment (25%) was reduced compared to patients who only received dexamethasone. There was a rapid and sustained improvement in macular edema, though there was no statistically significant improvement in visual acuity. Intraocular pressure initially increased but stabilized after the first 3-month interval.
CONCLUSIONS: Sequential administration of dexamethasone and fluocinolone acetonide intravitreal implants reduces the rate of significant macular edema recurrences in non-infectious uveitis. There is a significant quantitative improvement in macular edema, and further studies may demonstrate a noticeable benefit in visual acuity and quality of life with fewer retreatments.
PMID:42341355 | DOI:10.1016/j.jfo.2026.104935
