EFFECTIVENESS OF THE INTRAVITREAL DEXAMETHASONE IMPLANT IN THE MANAGEMENT OF REFRACTORY UVEITIC MACULAR OEDEMA: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS AND PRIMARY STUDIES

Vollständiger Abstract

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Introduction. Macular oedema is the single most important structural cause of irreversible central visual loss in non-infectious uveitis, and a substantial proportion of eyes remain oedematous despite topical, periocular, systemic corticosteroid, immunomodulatory, or anti-VEGF therapy. The biodegradable 0.7 mg intravitreal dexamethasone implant (Ozurdex®) delivers sustained intravitreal corticosteroid over approximately six months and has become a widely used option for refractory disease, yet the magnitude, durability, and safety of its effect specifically in refractory uveitic macular oedema have never been quantified across the entire primary evidence base. Methods. The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Eligible: RCTs, prospective and retrospective cohorts, case-control, cross-sectional, and observational interventional series with ≥5 eyes. Risk of bias assessed with RoB 2 and ROBINS-I; GRADE for certainty. Results. Thirty-five reports from 33 independent study populations comprising 1,871 eyes. Central macular thickness fell by −156.8 µm at month 1 (95%CI −184.9 to −128.7; P