Intravitreal corticosteroids (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card.  This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids.  For more information, including which patients should receive the card, see HIS for details.  Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

See Peri-operative guidelines for patients with or at risk of adrenal insufficiency

DEXAMETHASONE

Therapy notes

  • Also for specialist treatment of inflammation of the posterior segment of the eye presenting as non-infectious uveitis.

Formulation and dosage details

Formulation:

Intravitreal implant 700 micrograms (s)

Dosage:

As per SMC652/10: treatment of adult patients with macular oedema following either branch retinal vein occlusion or central retinal vein occlusion.
SMC restriction: for use in adult patients with macular oedema (i) following central retinal vein occlusion (CRVO) and (ii) in patients with branch retinal vein occlusion (BRVO) who are not clinically suitable for laser treatment including patients with dense macular haemorrhage or patients who have received and failed on previous laser treatment.

See also NICE TA460: Adalimumab and dexamethasone for treating non-infectious uveitis (published July 2017).

FLUOCINOLONE ACETONIDE

Therapy notes

Formulation and dosage details

Formulation:

Intravitreal implant 190 micrograms (hospital use only)

Dosage:

As per SMC 864/13: treatment of vision impairment associated with chronic diabetic macular oedema, considered insufficiently responsive to available therapies.

SMC restriction:

  • only in patients in whom the affected eye is pseudophakic (has an artificial lens after cataract surgery) and;
  • retreatment would take place only if the patient had previously responded to treatment
    with fluocinolone acetonide and subsequently best corrected visual acuity had deteriorated to less than 20/32.

and SMC 2260: prevention of relapse in recurrent non-infectious uveitis affecting the posterior segment of the eye.

Editorial Information

Document Id: F204