Clinical trial study funded by the National Eye Institute (NEI) reported that systemic therapy consisting of corticosteroids and immunosuppressant restored vision of uveitis patients with few side effects as compared to corticosteroid intraocular implant.
Visual acuity of patients was observed to be stable among participants on systemic therapy after seven years but declined by an average of six letters (about one line on an eye chart) among participants who had the implant. The findings of the study were published in the Journal of the American Medical Association in May 2017. Although implant were effective at controlling inflammation, local ocular side effects were observed. “This trial provides good evidence that for the average patient with Uveitis, systemic therapy would be the first choice of treatment,” said John Kempen, M.D, Ph.D., of Massachusetts Eye and Ear/Harvard Medical School, Boston.
Systemic corticosteroids therapy reduce acute inflammation effectively. It has systemic adverse effects when used at a high dose for a long time. As a part of the study, Researchers randomly assigned 255 uveitispatients at 23 to receive the fluocinolone implant or systemic treatment with corticosteroids and immunosuppressant. The immunosuppressant inhibit pathological immune responses, thus reducing the amount of corticosteroids. The researchers found that implant-treated eyes had reactivations of uveitis after about five years, which coincided with a decline in visual acuity. The loss of vision in the implant group appears to have been due to increased damage in the retina and choroid.
According to Uveitis Treatment Market report published by Coherent Market Insights, Uveitis is caused by various factors such as inflammatory diseases, injuries in the eye, microbial infections such as viral, bacterial, and fungal infection or exposure to certain toxic chemicals such as strong acids or pesticides. However, in many cases the cause of this condition remains unknown. The results of this trial suggest that oral corticosteroids and immunosuppression may be a preferable initial choice for therapy of more severe uveitis. However, the implants may have a role in treating patients where systemic therapy fails to control inflammation or patients cannot tolerate the oral medications.