Short Term Results of Fluocinolone Acetonide Intravitreal Implant (Iluvien®) for Diabetic Macular Edema in Highly Treated Eyes

Abstract

Purpose : To investigate the post marketing anatomical and clinical effects of 0.19 mg fluocinolone acetonide (Iluvien®) intravitreal implant in highly treated eyes of patients with diabetic macular edema (DME).

Methods : Patients treated with intravitreal fluocinolone acetonide for the treatment of DME were identified at a single retina only group practice. A retrospective chart review was performed. All patients included in the study who had received a single injection of 0.19 mg fluocinolone acetonide had received prior treatments with one or more agents including bevacizumab, ranibizumab, triamcinolone or dexamethasone steroid implant. Data collected included age, gender, prior treatments, agent of choice for steroid challenge, as well as best-corrected visual acuity (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) before and after treatment.

Results : Ten eyes of eight patients were identified. The mean age was 69. Seven were female and one was male. Prior treatments included: two focal laser photocoagulation (four eyes), six prior bevacizumab treatments (two eyes), thirteen prior ranibizumab treatments (five eyes), three prior intravitreal triamcinolone acetonide 4.0mg/0.1ml (IVTA) treatments (eight eyes), one prior subtenon triamcinolone acetonide 40mg/1.0ml treatment (one eye), and three prior intravitreal dexamethasone steroid implants (nine eyes). None of the eyes received prior treatment with aflibercept. Nine of the ten eyes were steroid challenged with intravitreal dexamethasone implant and one eye was challenged with intravitreal triamcinolone acetonide. Three-month follow up was available (average of 103 days following fluocinolone acetonide injection). The average logMAR acuity was 0.624 at baseline and 0.61 at last follow up (P = 0.834). The average IOP was 18 mmHg at baseline and 19.8 mmHg at last follow up (P = 0.165). The average CRT was 425.1 μm at baseline and 297.2 μm at last follow up (P = 0.079).

Conclusions : Intravitreal fluocinolone acetonide appears to have a positive trend on central retinal thickness in highly treated eyes with diabetic macular edema with no statistically significant change in intraocular pressure. Limitations include a small cohort and short-term follow up. Six-month follow up is anticipated at the time of the 2016 ARVO Annual Meeting.

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