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EARLY TREATMENT RESPONSE OF FLUOCINOLONE (RETISERT) IMPLANTATION IN PATIENTS WITH UVEITIC MACULAR EDEMA: An Optical Coherence Tomography Study

Purpose: To analyze the early spectral domain optical coherence tomography changes after fluocinolone implantation in eyes with baseline uveitic macular edema. Methods: Patients with uveitic macular edema and who received fluocinolone implantations by 2 surgeons (R.P.S. and J.E.S.) at the Cole Eye Institute (Cleveland Clinic, Cleveland, OH) from September 2009 to July 2010 were eligible for this study. Best-corrected visual acuity, intraocular pressure, central subfield thickness, cube volume, cube average thickness, and cystoid macular edema grade were recorded before implantation and in the early postoperative period (median: 3 months postimplantation). Changes in these variables were analyzed using the Wilcoxon signed-rank test for paired comparisons of clustered data. P values were 2 sided, and alpha was set at 0.05. Results: Twelve eyes of seven patients were included in the study. The median best-corrected visual acuity improved in the early postoperative period after implantation (20/80 before implantation and 20/50 after implantation), but this improvement was not found to be significant (P = 0.12). However, the spectral domain optical coherence tomography measurements—central subfield thickness, cube volume, cube average thickness, and cystoid macular edema grade—were all significantly reduced (median changes: −234 &mgr;m [P = 0.02], −1 mm3 [P = 0.04], −39 &mgr;m [P = 0.04], and −3 [P = 0.03], respectively). Conclusion: Fluocinolone implantation is associated with a significant reduction in macular edema as measured by spectral domain optical coherence tomography in the early postoperative period, a result that is consistent with the proposed mechanism of the drug.