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General

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Table 1. Sustained-release Steroid Options19-23

  Indication Delivery Duration/

Efficacy

Contraindications Complications Adverse Events
Fluocinolone Acetonide
Yutiq

(0.18 mg, EyePoint Pharmaceuticals)

Non-infectious posterior uveitis Intravitreal, non-bioerodible Up to 36 months Active ocular infection, avoid in aphakia Post-injection endophthalmitis 56% of patients developed a cataract within 1 year; 43% were on at least one IOP-lowering medication; 2% required glaucoma surgery
Retisert

(0.59 mg, Bausch + Lomb)

Chronic non-infectious posterior uveitis, patients who cannot tolerate systemic therapy Surgically implanted and sutured at pars plana Up to 30 months Active ocular infection, consider systemic therapy if patients also have systemic disease and bilateral ocular disease Surgical complications of hypotony and vitreous hemorrhage; post-operative complications of wound site erythema, dehiscence, hypotony (9.4%), and scleral thinning over implant Within 3 years, 77% of patients require IOP drops, 37% require filtering procedures, and nearly all phakic eyes require cataract surgery
Dexamethasone
Ozurdex

(0.7 mg, Allergan)

Diabetic macular edema, retinal vein occlusion-associated macular edema, non-infectious posterior uveitis Intravitreal, bioerodible 3 to 4 months Active ocular infection, advanced glaucoma, or when posterior lens capsule is not intact (risk of anterior chamber migration) Post-injection endophthalmitis and hypotony (from wound leak) High incidence of cataract development compared to sham; IOP rise typically 4 to 6 weeks following injection
Triamcinolone Acetonide
Xipere

(4 mg/0.1 mL, Bausch + Lomb)

Macular edema associated with uveitis Supra-

choroidal

Treatment response noted up to 9 months in 50% of patients Active ocular infection, known hypersensitivity to triamcinolone acetonide Resistance during injection due to not being in the correct anatomical space; injection site pain IOP elevation >10 mmHg from baseline in 14.3%; lower rates of cataract compared with intravitreal options

 

 

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