Steroids Blog

A surgical implant, which is sutured to the sclera, is a useful second-line therapy for patients with sympathetic ophthalmia who have recurrent inflammation or can’t tolerate systemic anti-inflammatory medications. Researchers said that the implant, an approved noninfectious uveitis treatment, releases low doses of steroid helps prevent inflammation and stabilize vision in patients with sympathetic ophthalmia.

In a retrospective study, three of the patients regained vision because of resolution of inflammation and macular edema. Vision was stabilized in the remainder of the patients, and none of them lost vision because of the device or ongoing sympathetic ophthalmia.

From Medpage today:

“Until recently, the primary treatment option for sympathetic ophthalmia was nonsurgical and involved high doses of oral steroids followed by oral immunosuppressive medication to preserve vision in a patient’s remaining eye,” said lead author Vinit Mahajan, M.D., Ph.D., also of the University of Iowa Hospitals and Clinics.

But such systemic treatment, he said in a statement, “subjects patients to life-long use of immunosuppressive drugs that have serious side effects such as osteoporosis, weight gain, potentially life-threatening infection, and liver or kidney damage.”

To evaluate the effects of the implant in cases of sympathetic ophthalmia, the researchers looked at records of eight patients who underwent surgical implantation of the device with post-operative follow-up from three months to two years.

The results support the use of the implant in sympathetic ophthalmia, the researchers said, although the “conclusions have to be tempered” because of the small number of patients and the retrospective nature of the study.

Sympathetic ophthalmia is a rare condition in which, after surgery on or trauma to one eye, the other becomes inflamed in an autoimmune response. Although the implant has found to be effective, it still needs to be replaced after two and a half years since sympathetic ophthalmia is a chronic disease.