Multi-center Uveitis Steroid Treatment Study (MUST)

Multi-center Uveitis Steroid Treatment Study (MUST)

An interventional, randomized, open-label, controlled clinical trial

Purpose: To compare standard medical therapy (immunosuppressants pills taken by mouth) for uveitis with the Retisert (fluocinolone acetonide) depot implant.

Status: Ongoing recruitment


A randomized, interventional, parallel-assignment, controlled clinical trial studying the effectiveness of standardized systemic therapy versus fluocinolone acetonide implant therapy for the treatment of severe cases of non-infectious intermediate uveitis, posterior uveitis, or panuveitis.

Primary outcome measures:

Difference in visual acuity at two years of follow-up

Secondary outcome measures:

Retinal morphology, Intraocular inflammation, Potential ocular complications of uveitis and of therapy, Adverse event tracking

Mortality, cost-effectiveness, quality of life

No treatment masking for providers or patients

Making applied to clinic visits at baseline, 6 month f/u, and thereafter

Patients followed until death, withdrawal, or closure of study


  1. Argon Study: All trials (AMD, POH, INVM) halted early due to dramatic reduction in severe VA loss with argon laser treatment
  2. Krypton Study:
    1. Beneficial effect for krypton red laser treatment in eyes with AMD, most pronounced in normotensive patients (not apparent among pts with HTN).
    2. POH patients with significant benefit from krypton red laser
    3. Results in INVM patients were intermediate between AMD and POH.
  3. Foveal Study:
    1. Generally, eyes with AMD and subfoveal CNV benefitted from laser
    2. Initially, laser-treated eyes had immediately lost more vision than observed eyes; this loss was similar to the untreated group at 12 months


  1. For patients with well-demarcated classic CNV from AMD, POH, or INVM, treatment with laser photocoagulation, performed according to MPS guidelines, had better visual prognosis
  2. Likewise, patients with extrafoveal and juxtafoveal CNV from AMD, POH, or INVM had better visual prognosis with laser photocoagulation.
  3. Eyes with AMD and subfoveal CNV:
    1. Eyes with smaller lesion and worse initial VA had greater and earlier benefits of laser treatment
    2. Eyes with large subfoveal CNV lesions and good initial VA are not good candidates for focal laser photocoagulation