Incidence and Management of Ocular Hypertension Following the 0.18 mg Fluocinolone Acetonide Implant for Non-infectious Uveitis affecting the Posterior Segment.

Abstract

To investigate the real-world incidence and management of ocular hypertension (OHT) following intravitreal 0.18mg fluocinolone acetonide implant (FAi, Yutiq) for non-infectious uveitis affecting the posterior segment (NIU-PS). Retrospective review of eyes treated with 0.18 mg FAi (2019-2025) with ≥1 month follow-up. Primary outcome was OHT (IOP >24 mmHg). Secondary outcomes included IOP ≥30 mmHg, >12 mmHg IOP increase from baseline, and OHT treatment. A total of 275 FAi-treated eyes (178 patients, mean age: 62.87 years) were included. Patients received an average of 1.05 FAi (range:1-2), with mean follow-up of 20.59 ± 0.72 months. Mean baseline IOP was 14.30 ± 3.90 mmHg. Glaucoma and OHT were present in 28.4% and 32.4% of eyes, respectively and 38.5% were on IOP-lowering therapy. Supplemental corticosteroid injections were required in 31.3%. The OHT rate after FAi was 10.5%. Elevated IOP ≥30 mmHg occurred in 5.82%. IOP >12 mmHg from baseline occurred in 7.3%. Among OHT eyes, 41.4% resolved with observation, 44.8% required topical therapy (mean 1.78 agents), and 10.3% required incisional surgery. Higher baseline IOP (adjusted OR 1.41 per 1 mmHg increase, 95% CI:1.19-1.67) and baseline IOP-lowering medication use (OR 8.56, 95% CI:2.61-28.11) were the strongest predictors of rise in IOP. FAi for the treatment of NIU-PS was associated with low rates of OHT, reinforcing its safety. Eyes with higher baseline IOP and those on prior IOP-lowering medications had a substantially increased risk of OHT, highlighting the need for closer IOP monitoring in this subgroup.