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Intravitreal corticosteroids superior in treatment of uveitic macular edema
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CHICAGO — Intravitreal triamcinolone and intravitreal dexamethasone sustained-release implant were both superior to periocular triamcinolone for the regional treatment of uveitic macular edema, according to a speaker here.
The multicenter, randomized POINT clinical trial included patients with macular edema with or without active uveitis randomly assigned to one of three treatment groups. Patients received 40 mg of periocular triamcinolone, 4 mg of intravitreal triamcinolone or Ozurdex (dexamethasone intravitreal implant 0.7 mg, Allergan). Researchers evaluated the primary outcome of central subfield thickness at 8 weeks compared with baseline with OCT by masked readers, Jennifer E. Thorne, MD, PhD, said at Uveitis Subspecialty Day preceding the American Academy of Ophthalmology meeting.
“Our three primary efficacy hypotheses, the data from POINT did support them. Intravitreal triamcinolone was superior to periocular triamcinolone, intravitreal dexamethasone was superior to periocular triamcinolone, and intravitreal dexamethasone was noninferior to intravitreal triamcinolone for the treatment of uveitic macular edema,” Thorne said.
Overall, patients responded to any of the three treatments. There were improvements in central subfield thickness for all patients at 8 weeks. However, both intravitreal treatments statistically significantly outperformed periocular triamcinolone at the primary outcome visit. Dexamethasone appeared to be noninferior to intravitreal triamcinolone acetonide at the primary outcome visit, Thorne said.
The intravitreal treatment groups showcased better improvement in macular edema, a greater than 20% decrease in retinal thickness, in a higher proportion of patients than the periocular treatment, Thorne said.
“Visual acuity also tended to mirror the responses we saw with the improvements in macular edema. Even though all three groups did show improvement in visual acuity over time with each treatment, the intravitreal groups tended to outperform the periocular group by about a line of visual improvement at 8 weeks,” she said. – by Robert Linnehan
Reference:
Thorne JE. Late breaking developments: POINT trial results. Presented at: AAO Subspecialty Day; Oct. 26-27, 2018; Chicago.
Disclosure: Thorne reports she receives grants from NEI/NIH and Allergan, is on the advisory boards for AbbVie, Aldeyra and Santen, and is a consultant for ClearView, Gilead and NightstaRx.