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Frequent follow-up of IOP advised for uveitis patients with corticosteroid implants
 David S. Friedman |
NEW YORK — Frequent follow-up to monitor IOP in patients with uveitis treated with fluocinolone acetonide implants was advised by one presenter here.
David S. Friedman, MD, MPH, PhD, said at the American Glaucoma Society annual meeting that patients may not report symptoms because uveitis is reduced with the implant. This may lead to poor follow-up, he said, but increases in IOP are common in the first year and beyond, and changes in IOP can occur suddenly.
In reporting 2-year data for the incidence and risk factors for glaucoma and IOP elevation in patients treated with fluocinolone acetonide implants for uveitis enrolled in the Multicenter Uveitis Steroid Treatment Trial, Dr. Friedman said, "You have to monitor pressure in these patients, and these patients need to be aware of that, because they are at risk for severe changes over short periods of time."
The trial compared systemic treatment with implant treatment of uveitis inflammation. Baseline IOP was 24 mm Hg or less at enrollment, and participants underwent glaucoma grading evaluations.
"Inflammation was better controlled with the implant," Dr. Friedman said. However, IOP increased by 10 mm Hg or more in a large proportion of implant patients and continued throughout the second year, he said. In the systemically treated patients, the IOP increases were considerably smaller.
Of the 35 participants in both groups in whom incident glaucoma developed, only four participants had never been treated with the implant, he said.
"Glaucoma is common and can occur suddenly," Dr. Friedman said.
- Disclosure: Dr. Friedman is a consultant to Bausch + Lomb, but not on matters related to this product or products used to treat uveitis.