September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Change in retinal function and morphology in patients with Diabetic macular edema switching from anti-VEGF to steroid (Fluocinolone acetonide)
Author Affiliations & Notes
  • Radha Das
    School of Medicine, Queens University, Belfast, BELFAST, United Kingdom
  • Usha Chakravarthy
    School of Medicine, Queens University, Belfast, BELFAST, United Kingdom
  • Footnotes
    Commercial Relationships   Radha Das, None; Usha Chakravarthy, Alimera Sciences (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3282. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Radha Das, Usha Chakravarthy; Change in retinal function and morphology in patients with Diabetic macular edema switching from anti-VEGF to steroid (Fluocinolone acetonide). Invest. Ophthalmol. Vis. Sci. 2016;57(12):3282.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To identify the change in the anatomic features on spectral domain optical coherence tomography (SD-OCT) and visual acuity in patients with diabetic macular edema (DME) when switched from anti-VEGF to Fluocinolone acetonide (Iluvien) treatment.

Methods : Retrospective observational case series of patients with DME attending a retina clinic in Belfast, UK from Dec 2013 to Apr 2015.The pre-switch eligibility for anti VEGF therapy was patients with DME with central foveal thickness (CFT) or maximum retinal thickness (MRT) > 400µ, MRT within 500 µ from fovea and best corrected visual acuity (BCVA) > 23 letters. Eligibility for switch to Iluvien treatment included an insufficient response to anti-VEGF after minimum 3 three treatments with residual edema >350µ and psuedophakia. BCVA was available along with SD-OCT of the macular retina. SD-OCT images were graded for intra retinal fluid (IRF) localisation and shape of DME, intactness of external limiting membrane (ELM), ellipsoid zone (EZ), and the outer hyper reflective bands constituting Bruch’s, RPE and choriocapillaris complex, choroidal thickness (CT) at the fovea and the vitreomacular interface.
Statistical analysis consisted of comparison of means of BCVA, OCT metrics and grading of outer retinal architecture at baseline, switch, 3 months and 6 months. Regression analysis was used to determine the baseline and 6 month predictors of 6 month BCVA.

Results : Of the 210 patients with DMO, 27 were deemed eligible for switch and data from 21 eyes with 6 months follow up after switch are included. The mean change in BCVA from switch to 3 months and 6 months was not statistically significant (p=0.07). Change in CFT, MRT was statistically significant (p=0.002, p<0.001,) but CT was not (p = 0.18). The number of eyes exhibiting an intact ELM or EZ increased at 6 months. Predictors of BCVA at 6 months was baseline BCVA, ELM, EZ, RPE intactness.

Conclusions : 1.Post switch to Iluvien improvements are seen in morphological metrics.
2.Predictors of functional outcome at 6 months include outer retinal morphology.
3.The proportion of eyes with intact outer retinal morphology increased with Iluvien treatment.
4.Our findings supports the use of Iluvien when there is a suboptimal response to anti-VEGF

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×