June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Efficacy and safety of Fluocinolone acetonide implant use for the treatment of refractory diabetic macular oedema and its impact on the hospital diabetic eye services
Author Affiliations & Notes
  • Anastasios Sepetis
    Portsmouth Hospitals NHS Trust, Portsmouth, Hants, United Kingdom
  • Spyridon Mourtzoukos
    Portsmouth Hospitals NHS Trust, Portsmouth, Hants, United Kingdom
  • Footnotes
    Commercial Relationships   Anastasios Sepetis, Alimera Sciences (R); Spyridon Mourtzoukos, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 85. doi:
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      Anastasios Sepetis, Spyridon Mourtzoukos; Efficacy and safety of Fluocinolone acetonide implant use for the treatment of refractory diabetic macular oedema and its impact on the hospital diabetic eye services. Invest. Ophthalmol. Vis. Sci. 2017;58(8):85.

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

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Abstract

Purpose : Fluocinolone acetonide slow release implant (Iluvien, FAc) is recommended by the National Institute for Health and Care Excellence in UK, as an option for treating chronic diabetic macular oedema (DMO) in pseudophakic patients that do not respond to anti-VEGF and/or laser treatments (LT). We performed a retrospective audit to assess the efficacy and safety of the clinical use of FAc and its impact to the clinical load at Queen Alexandra Hospital in Portsmouth.

Methods : Eighteen eyes from sixteen pseudophakic patients with chronic DMO, treated with FAc, were investigated to evaluate baseline visual and anatomical characteristics and outcomes at 3, 6, 12 and 18 months post FAc implant (n= 18, 17, 9, and 5 eyes, respectively). More specifically, the outcome measures studied were best corrected visual acuity (BCVA), central macular thickness (CMT) and central macular volume (CMV). Intraocular pressure (IOP) and adverse events were studied for the safety profile and number of visits/ trimester, before and after the FAc implant were recorded.

Results : Sixteen patients were included with a mean age 71.7±8.4 years and mean duration of DMO 5.6 years. The male to female ratio was 1:1 with one patient of each gender receiving billateral FAc. The mean number of previous anti-VEGF injections was 8.3± 3.2 and they had received in total 15 LT with 2 eyes having received no LT. At baseline, mean BCVA, CMT and CMV were 65.6±11.6 ETDRS letters, 459±106.7 μm and 0.36±0.1 μm3, (mean± SD), respectively. CMT and CMV were reduced in 15 eyes and BCVA was improved or maintained in 13 eyes. IOP remained stable and ≤21mmHg in 16 eyes with the two additional patients requiring IOP-lowering medication after 12 and 18 months. Three eyes required additional anti-VEGF treatment, two additional patients required bilateral anti-VEGF with one of them requiring Dexamethasone intravitreal implants as well, after one year. Hospital visits were reduced from 2.2±0.6 to 1.5±0.7 visits per trimester (31.6% reduction, mean±SD, p<0.01).

Conclusions : Treatment of refractory DMO with FAc (Iluvien) is effective in improving visual outcome and anatomical characteristics and can reduce the number of necessary visits in such complex cases, while retaining an acceptable safety profile. Careful selection of patients could improve the outcome and reduce adverse events.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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