[Glucocorticosteroid intravitreal implants in posterior retina diseases]

Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Rey-Ares L, Cesaroni S
Record ID 32014000300
Authors' objectives: To assess the available evidence on the efficacy, safety and issues related coverage policies for the use of dexamethasone and fluocinolone intravitreal implants.
Authors' recommendations: Studies of good methodological quality have been identified on the use of dexamethasone implants in patients with VRO and NUPI, in which different doses of dexamethasone implants were compared versus placebo and showing a statistically significant improvement in visual acuity in patients with VRO who received implants at Days 30, 60 and 90 after implantation but not at Day 180 and a higher rate of eyes without inflammation in patients with NUPI. The selected RCTs conducted on the use of fluocinolone in patients with NUPI or DR showed a high rate of adverse effects (increased IOP and cataracts). No good methodological quality studies have been identified on the use of FA implants in patients with VRO. One study was identified and included just 30 patients and compared the administration of dexamethasone implants using an applicator or by means of an incision, which showed not significant differences. No RCTs directly comparing the different types of intravitreal GC or on the efficacy and safety of using more than two implants successively have been identified. No evidence was found on the use of Ozurdex® in patients with relapsed ME. Although intravitreal triamcinolone is currently used, no RCTs comparing this intervention with GC implants have been identified. In summary, there is adequate information to support the use of GC intravitreal implants in posterior retina diseases, especially about dexamethasone, but the effectiveness against the triamcinolone injections has not been reported. Also, the advantage of using the applicator has not been evaluated either.
Project Status: Completed
Year Published: 2012
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Humans
  • Retinal Diseases
  • Glucocorticoids
  • Drug Implants
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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