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An exploratory study of ranibizumab (Lucentis) for treatment of uveitic patients with refractory cystoid macular edema (the LIMO study)

Session Details

Session Title: Uveitis

Session Date/Time: Saturday 19/09/2015 | 11:00-12:30

Paper Time: 12:12

Venue: Hermes

First Author: : S.Degli Esposti UNITED KINGDOM

Co Author(s): :    A. Samy   O. Comyn   G. Rubin   C. Bunce   N. Okhravi   M. Michaelides

Abstract Details

PURPOSE:To evaluate the efficacy and safety of intravitreal Lucentis in patients with quiescent uveitis and visual loss secondary to uveitic macular oedema which had proven to be refractory or ineligible to standard of care therapy.

Setting:

Moorfields Eye Hospital, London, United Kingdom

Methods:

Open label, prospective, non-randomised, interventional case series. Ten patients (5 male) with uveitic macular oedema and quiescent uveitis were enrolled. Median age was 56.1 years (IQR 37.4, 68.2). All patients initially received 3 monthly injections of Lucentis following by re-injection according to clinical need in the study eye. Follow-up was 12 months. Baseline and serial assessments included best-corrected visual acuity (BCVA), contrast sensitivity, reading speed, microperimetry, and optical coherence tomography (OCT). Primary endpoints of the study were the number of eyes which responded to therapy and reduction of macular oedema as evaluated on OCT.

Results:

At enrolment, median duration of macular oedema was 30 months (22, 45). Median visual acuity in the study eye was 64 ETDRS letters (58, 68) and median contrast sensitivity in the study eye was 1.33 (1.20, 1.55). Median central macular thickness was 474 microns (407, 603). The median number of intravitreal injections over the study period was 7.5 (5, 9.5). Nine patients (90%) responded to therapy albeit with a variable reduction in macular oedema. At 6 months and at 12 months median visual acuity was 68 (53, 80) and 60 (42, 78) respectively. Three patients (30%) gained more than 15 letters; 3 patients (30%) lost more than 15 letters and no patient lost more than 30 letters. Median change in CMT was -42.5 microns (140, 4) and -5 microns (183, 100) at 6 and 12 months respectively. At 12 months median change in contrast sensitivity was 0.03 (-0.45, 0.65), median change in reading speed was 21.5 (-50, 36) and median change in macular sensitivity on microperimetry was 7.5 dB (-0.2, 13.2).

Conclusions:

A variable response to intravitreal Lucentis was observed in our small cohort of patients with chronic macular oedema and quiescent uveitis, but the majority of patients showed a response to treatment. This pilot study suggests a multi-centre randomized controlled trial would be worthy of consideration.

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