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Spyridon E Chalkiadakis, Fiona J Harris, Simon Taylor; Clinical effectiveness of the fluocinolone acetonide implant in diabetic macular oedema resistant to anti-VEGF therapy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3258.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal corticosteroid implants may be useful in treating diabetic macular oedema (DMO) refractive to standard therapies. FAME study for the fluocinolone acetonide (ILUVIEN®) implant recruited a few patients who had prior exposure to anti-VEGF therapy. We therefore performed a prospective observational study of the clinical effectiveness of intravitreal ILUVIEN implant in patients with DMO, unresponsive to conventional anti-VEGF therapy.
We performed a prospective observational study regarding the outcomes and side-effects in 26 eyes of 24 consecutive patients with DMO refractory to ranibizumab intravitreal injections, who were treated with the 0.19 µg Iluvien implant. All patients were pseudophakic at baseline. DMO was categorised into chronic (≥36 months) or non-chronic (<36 months).
After 9 months, 50% of both the chronic and non-chronic DMO groups gained ≥15 letters from baseline; the mean letter gains being +10.3 letters in the non-chronic DMO group and +20.5 letters in the chronic DMO group. The average Central Retinal Thicknesses (CRT) were 335 µm in the non-chronic DMO group and 375µm in the chronic DMO group - a decrease from baseline of 41 µm and 127 µm respectively. By month 9, 5/26 patients had raised intraocular pressure (IOP), requiring IOP-lowering medication; the IOP rises were similar in each group, at 7-8 mm Hg.
Patients with chronic DMO gained more letters on the ETDRS chart and had a greater reduction in CRT, on average, than those with DMO of less than 36 months’ standing. Nevertheless, both groups of patients responded well to the ILUVIEN implant despite being refractory to treatment with ranibizumab. The rate of raised IOP requiring treatment was approximately 20%.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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