Long-Term Treatment Outcomes with a Single 0.19 Mg Fluocinolone Acetonide Implant in Non-Infectious Uveitis - A Real-World Study

Purpose: To evaluate time to first additional treatment following intravitreal 0.19 mg fluocinolone acetonide (FAc) in non-infectious uveitis with posterior segment involvement (NIU-PS) in a real-world setting.

Methods: Prospective observational study on 37 eyes (30 patients) with chronic or recurrent NIU-PS, treated with FAc after achieving control - indicated by absence of vitreous haze or clearly visible posterior pole. Over a median follow-up of 48.0 ± 0.0 months, we assessed time to and number of additional treatments, inflammatory activity, central subfield macular thickness (CSMT), visual acuity (VA) and intraocular pressure (IOP).

Results: Restricted mean time to first adjuvant treatment was 31.9 ± 2.97 months, with 52.8% requiring no additional treatment ≥ 48 months. VA remained stable (baseline 0.56 ± 0.44 logMAR,  = 0.86). A negative correlation was found between the number of prior steroid implants (DEX-I) and time to additional treatment ( = -0.44,  = 0.001). For up to 24 months, FAc reduced anterior chamber flare (0.44 ± 0.81 to 0.00 ± 0.00,  < 0.001), vitreous haze (0.28 ± 0.51 to 0.00 ± 0.00,  = 0.01), and CSMT (407.1 ± 135.9 µm at baseline to 324.2 ± 75.7 µm at M24,  = 0.001). Within 48 months, ocular hypertension (≥25 mmHg) occurred in 22.2% of eyes (8/36), with 19.4% (7/36) requiring new-onset IOP-lowering drops.

Conclusion: FAc demonstrated efficacy in managing low-grade NIU-PS, reducing the need for additional treatments and controlling intraocular inflammation for an average of 32 months.