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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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