AIM:To evaluate the efficacy and safety of dexamethasone intravitreal implant for the treatment of noninfectious refractory uveitis and analyze its influence on application and dose of systemic corticosteroids and immunosuppressive agent.

METHODS: This was a retrospective, case series study conducted between January 2018 and September 2019, the patients with noninfectious refractory uveitis and treated with intravitreal implantation of dexamethasone intravitreal implant were included. The best corrected visual acuity(BCVA), central retinal thickness(CRT), vitreous haze score, and intraocular pressure(IOP)at 1mo, 2mo, 4mo and 6mo after the implantation of dexamethasone intravitreal implant were compared with the baseline. Meanwhile, the dosage of corticosteroids and immunosuppressive agent used before and after the implantation of dexamethasone was also evaluated. The data was displayed as mean±standard deviation and analyzed using the paired t-test.

RESULTS: A total of 19 patients(21 eyes)were included in the present study. The mean baseline BCVA of the included patients was 0.671±0.469, while the mean CRT was 369.667±177.100μm, and the mean intraocular pressure(IOP)was 14.252±3.181mmHg. One month, 2mo, 4mo and 6mo after the injection of Ozrudex, BCVA was significantly improved compared with the baseline(P<0.05), while the CRT and vitreous haze score were significantly reduced(P<0.05, P<0.05). During the follow-up period, IOP of several patients significantly increased, but normal IOP can be observed at the end of the follow-up for all included patients. At baseline, 6 patients(6 eyes)were treated with systemic corticosteroids with an average dosage of 35.8mg/d, while only 2 patients were treated with systemic corticosteroids at the end of the 6mo follow-up(5mg/d). Apart from 3 eyes with Behcet's disease which showed recurrence of macular edema between 4-6mo, no other patient underwent that.

CONCLUSION: Dexamethasone intravitreal implantis considered to be a safe and effective approach for non-infectious refractory uveitis which can reduce systemic medication, with significant improvement of BCVA, reduction of CRT, vitreous haze score and the dosage of systemic corticosteroids.