Periocular corticosteroid injections in uveitis

Effects and complications

H. Nida Sen, Susan Vitale, Sapna S. Gangaputra, Robert B. Nussenblatt, Teresa L. Liesegang, Grace A. Levy-Clarke, James T. Rosenbaum, Eric B. Suhler, Jennifer Thorne, C. Stephen Foster, Douglas A. Jabs, John H. Kempen

Research output: Contribution to journalArticle

Abstract

Purpose To evaluate the benefits and complications of periocular depot corticosteroid injections in patients with ocular inflammatory disorders.

Design Multicenter, retrospective cohort study.

ParticipantsA total of 914 patients (1192 eyes) who had received ≥1 periocular corticosteroid injection at 5 tertiary uveitis clinics in the United States.

Methods Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics were obtained at every visit via medical record review by trained reviewers.

Main Outcome Measures Control of inflammation, improvement of visual acuity (VA) to ≥20/40, improvement of VA loss attributed to macular edema (ME), incident cataract affecting VA, cataract surgery, ocular hypertension, and glaucoma surgery.

Results Among 914 patients (1192 eyes) who received ≥1 periocular injection during follow-up, 286 (31.3%) were classified as having anterior uveitis, 303 (33.3%) as intermediate uveitis, and 324 (35.4%) as posterior or panuveitis. Cumulatively by ≤6 months, 72.7% (95% CI, 69.1-76.3) of the eyes achieved complete control of inflammation and 49.7% (95% CI, 45.5-54.1) showed an improvement in VA from

Conclusions Periocular injections were effective in treating active intraocular inflammation and in improving reduced VA attributed to ME in a majority of patients. The response pattern was similar across anatomic locations of uveitis. Overall, VA improved in one half of the patients at some point within 6 months. However, cataract and ocular hypertension occurred in a substantial minority.

Original languageEnglish (US)
Pages (from-to)2275-2286
Number of pages12
JournalOphthalmology
Volume121
Issue number11
DOIs
StatePublished - Nov 1 2014

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Intraocular Injections
Uveitis
Visual Acuity
Adrenal Cortex Hormones
Cataract
Ocular Hypertension
Macular Edema
Inflammation
Cohort Studies
Intermediate Uveitis
Panuveitis
Anterior Uveitis
Eye Diseases
Immunosuppressive Agents
Glaucoma
Medical Records
Retrospective Studies
Demography
Outcome Assessment (Health Care)
Injections

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Sen, H. N., Vitale, S., Gangaputra, S. S., Nussenblatt, R. B., Liesegang, T. L., Levy-Clarke, G. A., ... Kempen, J. H. (2014). Periocular corticosteroid injections in uveitis: Effects and complications. Ophthalmology, 121(11), 2275-2286. https://doi.org/10.1016/j.ophtha.2014.05.021

Periocular corticosteroid injections in uveitis : Effects and complications. / Sen, H. Nida; Vitale, Susan; Gangaputra, Sapna S.; Nussenblatt, Robert B.; Liesegang, Teresa L.; Levy-Clarke, Grace A.; Rosenbaum, James T.; Suhler, Eric B.; Thorne, Jennifer; Foster, C. Stephen; Jabs, Douglas A.; Kempen, John H.

In: Ophthalmology, Vol. 121, No. 11, 01.11.2014, p. 2275-2286.

Research output: Contribution to journalArticle

Sen, HN, Vitale, S, Gangaputra, SS, Nussenblatt, RB, Liesegang, TL, Levy-Clarke, GA, Rosenbaum, JT, Suhler, EB, Thorne, J, Foster, CS, Jabs, DA & Kempen, JH 2014, 'Periocular corticosteroid injections in uveitis: Effects and complications', Ophthalmology, vol. 121, no. 11, pp. 2275-2286. https://doi.org/10.1016/j.ophtha.2014.05.021
Sen HN, Vitale S, Gangaputra SS, Nussenblatt RB, Liesegang TL, Levy-Clarke GA et al. Periocular corticosteroid injections in uveitis: Effects and complications. Ophthalmology. 2014 Nov 1;121(11):2275-2286. https://doi.org/10.1016/j.ophtha.2014.05.021
Sen, H. Nida ; Vitale, Susan ; Gangaputra, Sapna S. ; Nussenblatt, Robert B. ; Liesegang, Teresa L. ; Levy-Clarke, Grace A. ; Rosenbaum, James T. ; Suhler, Eric B. ; Thorne, Jennifer ; Foster, C. Stephen ; Jabs, Douglas A. ; Kempen, John H. / Periocular corticosteroid injections in uveitis : Effects and complications. In: Ophthalmology. 2014 ; Vol. 121, No. 11. pp. 2275-2286.
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abstract = "Purpose To evaluate the benefits and complications of periocular depot corticosteroid injections in patients with ocular inflammatory disorders.Design Multicenter, retrospective cohort study.ParticipantsA total of 914 patients (1192 eyes) who had received ≥1 periocular corticosteroid injection at 5 tertiary uveitis clinics in the United States.Methods Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics were obtained at every visit via medical record review by trained reviewers.Main Outcome Measures Control of inflammation, improvement of visual acuity (VA) to ≥20/40, improvement of VA loss attributed to macular edema (ME), incident cataract affecting VA, cataract surgery, ocular hypertension, and glaucoma surgery.Results Among 914 patients (1192 eyes) who received ≥1 periocular injection during follow-up, 286 (31.3{\%}) were classified as having anterior uveitis, 303 (33.3{\%}) as intermediate uveitis, and 324 (35.4{\%}) as posterior or panuveitis. Cumulatively by ≤6 months, 72.7{\%} (95{\%} CI, 69.1-76.3) of the eyes achieved complete control of inflammation and 49.7{\%} (95{\%} CI, 45.5-54.1) showed an improvement in VA from Conclusions Periocular injections were effective in treating active intraocular inflammation and in improving reduced VA attributed to ME in a majority of patients. The response pattern was similar across anatomic locations of uveitis. Overall, VA improved in one half of the patients at some point within 6 months. However, cataract and ocular hypertension occurred in a substantial minority.",
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AU - Sen, H. Nida

AU - Vitale, Susan

AU - Gangaputra, Sapna S.

AU - Nussenblatt, Robert B.

AU - Liesegang, Teresa L.

AU - Levy-Clarke, Grace A.

AU - Rosenbaum, James T.

AU - Suhler, Eric B.

AU - Thorne, Jennifer

AU - Foster, C. Stephen

AU - Jabs, Douglas A.

AU - Kempen, John H.

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N2 - Purpose To evaluate the benefits and complications of periocular depot corticosteroid injections in patients with ocular inflammatory disorders.Design Multicenter, retrospective cohort study.ParticipantsA total of 914 patients (1192 eyes) who had received ≥1 periocular corticosteroid injection at 5 tertiary uveitis clinics in the United States.Methods Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Demographic and clinical characteristics were obtained at every visit via medical record review by trained reviewers.Main Outcome Measures Control of inflammation, improvement of visual acuity (VA) to ≥20/40, improvement of VA loss attributed to macular edema (ME), incident cataract affecting VA, cataract surgery, ocular hypertension, and glaucoma surgery.Results Among 914 patients (1192 eyes) who received ≥1 periocular injection during follow-up, 286 (31.3%) were classified as having anterior uveitis, 303 (33.3%) as intermediate uveitis, and 324 (35.4%) as posterior or panuveitis. Cumulatively by ≤6 months, 72.7% (95% CI, 69.1-76.3) of the eyes achieved complete control of inflammation and 49.7% (95% CI, 45.5-54.1) showed an improvement in VA from Conclusions Periocular injections were effective in treating active intraocular inflammation and in improving reduced VA attributed to ME in a majority of patients. The response pattern was similar across anatomic locations of uveitis. Overall, VA improved in one half of the patients at some point within 6 months. However, cataract and ocular hypertension occurred in a substantial minority.

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