An Update on Local Steroids for Uveitis

By
Sruthi Arepalli, MD
July 14, 2025
4 min

Retinal Physician

Overview

Recent changes in the availability and approval of local steroid therapies for uveitis have significant clinical implications. Notably, the discontinuation of Retisert and the relaunch of Triesence with a substantial price increase mark a new phase in uveitis care.

Background

Local steroids are a cornerstone in managing uveitic conditions, providing intraocular inflammation control without systemic immunosuppression. The fluocinolone acetonide intravitreal implant Retisert, approved in 2005, has been effective but associated with cataracts and glaucoma risks. Other options include injectable implants like Yutiq and dexamethasone-based Ozurdex. Market dynamics, including FDA approvals, manufacturing challenges, and corporate acquisitions, have recently altered the landscape of these therapies.

Data Highlights

Product	Active Ingredient	Dose	Duration	FDA Approval Indication	Notable Risks/Features	Recent Changes
Retisert	Fluocinolone acetonide	0.59 mg	~30 months	Chronic noninfectious posterior uveitis	Cataracts in nearly all phakic eyes by 3 years; 77% needed IOP-lowering meds; 37% required glaucoma surgery	Discontinuation announced for April 2026 due to manufacturing issues
Triesence	Triamcinolone acetonide	40 mg/mL injectable suspension	Short-acting injectable	Sympathetic ophthalmia, temporal arteritis, noninfectious uveitis, other ocular inflammation, vitrectomy aid	Preservative-free formulation; faced prolonged shortage; 486% price increase on relaunch	Relaunched late 2024 by Harrow with stabilized supply
Yutiq	Fluocinolone acetonide	0.18 mg	Up to 36 months	Chronic noninfectious posterior uveitis	Injectable intravitreal insert	US commercial rights transferred to Alimera, then acquired by ANI Pharmaceuticals in 2024
Iluvien	Fluocinolone acetonide	0.19 mg	Long-acting implant	Originally diabetic macular edema; expanded to chronic noninfectious posterior uveitis in US	Approved in Europe and Middle East for uveitis	Label expanded in 2024 post ANI acquisition
Ozurdex	Dexamethasone	0.7 mg	Short-acting implant	Various intraocular inflammatory conditions	Alternative to Retisert and Yutiq	Available as alternative treatment

Key Findings

Retisert, a 0.59 mg fluocinolone acetonide implant with ~30 months duration, will be discontinued in April 2026 due to manufacturing component shortages.
Retisert significantly reduces uveitis recurrences and systemic immunosuppression reliance but carries high risks of cataracts and glaucoma interventions.
Triesence, a preservative-free triamcinolone injectable, was unavailable during 2020–2022 but relaunched in late 2024 with a 486% price increase.
Yutiq, a 0.18 mg fluocinolone acetonide injectable implant approved in 2018, provides up to 36 months of steroid release for chronic noninfectious posterior uveitis; commercial rights changed hands multiple times, now owned by ANI Pharmaceuticals.
Iluvien, originally approved for diabetic macular edema, had its US label expanded in 2024 to include chronic noninfectious posterior uveitis, aligning with European indications.
No currently approved implant matches Retisert’s dose and duration, necessitating consideration of alternative therapies or systemic immunosuppression adjustments.

Clinical Implications

Clinicians should prepare for Retisert’s discontinuation by evaluating alternative local steroid options such as Yutiq and Ozurdex or adjusting systemic therapies. The relaunch of Triesence offers a preservative-free injectable option but at a significantly higher cost, which may impact treatment decisions. Awareness of label expansions, especially for Iluvien, broadens therapeutic choices for chronic noninfectious posterior uveitis.

Conclusion

The evolving availability and regulatory landscape of local steroid therapies for uveitis require clinicians to adapt treatment strategies. Despite challenges, multiple intravitreal steroid options remain to effectively manage intraocular inflammation while minimizing systemic exposure.