Intravitreal Dexamethasone Implant for Treatment of Sarcoidosis-Related Uveitis

Purpose: To assess the efficacy and safety of intravitreal dexamethasone implant injection in the management of sarcoidosis-related uveitis. Methods: A retrospective analysis was performed of the efficacy and safety of intravitreal dexamethasone implant injection for indications such as intractable vitritis, vasculitis, or cystoid macular edema. Results: This study comprised 20 patients with sarcoidosis-related uveitis. A single injection was performed in 13 eyes (65%) and 35% required more than 2 injections during the follow-up period [median 16.5 months (range 6–32)]. The best-corrected visual acuity showed significant improvement at 1 month (P = 0.004) and 3 months (P = 0.001), but there was no significance at 6 months after implant injection (P = 0.186). One month after treatment, the central macular thickness decreased to 278.95 ± 52.20 μm (P = 0.023). It further decreased to 274.70 ± 55.88 μm at 3 months (P = 0.027), but there was no significance at 6 months (280.65 ± 64.48 μm, P = 0.074).The anterior chamber cell grade (P = 0.003) and vitreous haze (P = 0.001) were significantly decreased for up to 6 months after a single implant injection. The most common ocular complication was worsening of cataracts during the first 6 months. Conclusion: Intravitreal dexamethasone implant injection is efficacious in reducing anterior chamber inflammation, vitreous haze, and cystoid macular edema in patients with sarcoidosis-related uveitis. Considering that sarcoidosis shows a chronic course of disease in a significant proportion of cases, intravitreal dexamethasone implant injection is a possible option to relieve intraocular inflammation.