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Ana Carolina Carolina Abreu, João Coelho, Bernardete Pessoa, Maria João Menéres, Angelina Meireles; Intravitreal Fluocinolone Acetonide and Intraocular Pressure: 1 year of follow-up in a clinical setting. Invest. Ophthalmol. Vis. Sci. 2017;58(8):946.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the first year tensional response to the intravitreal fluocinolone acetonide implant (Iluvien®) for chronic DME.
Retrospective, non-randomized, clinical data review of eyes with chronic DME treated with Iluvien®. Only patients with at least 1 year of follow-up were included in this analysis. Best-corrected visual acuity (BCVA; ETDRS letters) before and after treatment, previous intravitreal short-acting steroids and intraocular pressure status before, at baseline and during the follow-up were evaluated.
From the 15 eyes that met the inclusion criteria, 7 were already taking IOP lowering medication and one of these had also undergone Ahmed’s Valve implantation. Preceding Iluvien® implant, 14 eyes had received intravitreal injections of short-acting steroids, 5 of which started IOP lowering eye drops. At baseline, mean BCVA was 32.5 ± 11.4 ETDRS letters and at the last visit had increased by +18.3 ± 14.7 ETDRS letters (p <0.01). At baseline mean IOP was 15.6 ± 2.44 mmHg. At month 1, 3, 6, 9 and 12 it was observed an IOP value of 16.4 ± 2.6 mmHg (p 0.51), 17 ± 5.03 (p 0.53), 14.64 ± 1.8 mmHg (p 0.21), 18 ± 4.6 mmHg (p 0.10) and 18 ± 4.3 mmHg (p 0.08), respectively. When comparing IOP evolution in patients with previous OH and in the ones without OH, we only found statistically significant increases in IOP in those with previous OH; these differences occurred during all follow-up (p<0.05), except at 6 months (p 0.41). During the follow-up, in 26,7% (n=4) of the eyes it was observed an IOP value >21 mmHg, and in 2 of them there was no previous history of ocular hypertension. All cases were managed with IOP lowering eye drops with success, except for one in which surgery was required, namely cyclophotocoagulation.
Although there was an increase in IOP with the Iluvien® implant, ocular hypertension was observed in just 26.7% of the cases and there was a significant visual gain. Most of these cases can be easily managed only with IOP lowering eye drops.
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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