Outcome and risk of ocular complications of managing children with chronic anterior uveitis with topical rimexolone 1

Int Ophthalmol. 2020 May;40(5):1061-1068. doi: 10.1007/s10792-020-01358-9. Epub 2020 Apr 21.

Abstract

Purpose: To investigate the efficacy and safety of 1% rimexolone ophthalmic suspension in children with chronic anterior uveitis under real-life conditions in a tertiary center.

Methods: This is a retrospective longitudinal study. Medical records were analyzed at baseline, 1, 3, 6 and 12 months before and after switching to rimexolone for best-corrected visual acuity (BCVA), oral steroid use, number of flares, IOP and anti-glaucoma management.

Results: Twenty-four patients (41 eyes) diagnosed with either anterior uveitis (n = 25, 60.0%) or panuveitis (n = 16, 40%) were enrolled. The mean age was 10.5 years (4-16 years). The number of patients requiring oral prednisolone reduced from 8 patients (32.0%) at baseline to 3 patients (20.0%) at 12 months (P < 0.001). Following baseline, the median number of uveitis flares reduced from 2.0 (inter-quartile range (IQR) 1.0-2.75) to 1.0 (IQR 0.0-1.0) compared to the 12 months before baseline (P < 0.001). The mean IOP reduced from baseline (22.0 ± 7.3 mmHg) to 1 month (18.8 ± 8.7 mmHg, P = 0.01) and remained stable up to 12 months (15.9 ± 5.0 mmHg, P < 0.001). Average BCVA, dose of oral prednisolone and anti-glaucoma treatments did not change compared to the baseline. The development for IOP ≥ 30 mmHg was associated with a known corticosteroid response [odds ratio (OR) 6.8, P = 0.003] and a dose > 7.5 mg/day oral prednisolone (OR 4.4, P = 0.033).

Conclusions: Rimexolone 1% ophthalmic suspension is an effective and safe topical steroid for pediatric anterior uveitis.

Keywords: Intraocular pressure; Pediatric; Rimexolone; Uveitis.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Glaucoma / etiology*
  • Glaucoma / physiopathology
  • Glucocorticoids / administration & dosage
  • Humans
  • Intraocular Pressure / drug effects
  • Male
  • Ophthalmic Solutions / administration & dosage
  • Pregnadienes / administration & dosage*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Uveitis, Anterior / complications
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy*
  • Visual Acuity*

Substances

  • Glucocorticoids
  • Ophthalmic Solutions
  • Pregnadienes
  • rimexolone