July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Best corrected visual acuity(BCVA) and central macular thickness (CMT) outcomes after fluocinolone acetonide intravitreal implant (FAc) injection in multitreated chronic diabetic macular edema (DME) patients. Efficacy in a real life setting in the United States
Author Affiliations & Notes
  • Manuel Paez
    Retina, The Macula Center, Miami, Florida, United States
  • Eric William Deupree
    Retina, The Macula Center, Miami, Florida, United States
  • Michael John Tolentino
    Retina, The Macula Center, Miami, Florida, United States
  • Dana Madison Deupree
    Retina, The Macula Center, Miami, Florida, United States
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 398. doi:
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      Manuel Paez, Eric William Deupree, Michael John Tolentino, Dana Madison Deupree; Best corrected visual acuity(BCVA) and central macular thickness (CMT) outcomes after fluocinolone acetonide intravitreal implant (FAc) injection in multitreated chronic diabetic macular edema (DME) patients. Efficacy in a real life setting in the United States. Invest. Ophthalmol. Vis. Sci. 2018;59(9):398.

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

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Abstract

Purpose : There have been some reports regarding the safety and efficacy of FAc in eyes of patients with refractory DME that didn’t respond to alternative therapies, these reports, however, have come from Europe; hence, the purpose of this study was to evaluate the efficacy of fluocinolone implant in a real-life setting in the United States

Methods : A retrospective observational case series involving 37 patients and 54 eyes, treated with FAc from February 2015 to November 2017 for DME. BCVA, CMT, intraocular pressure(IOP), follow-up before and after injection, and cataract surgery were measured. The patient population was treated with at least; ocular steroids, anti-vascular endothelial growth factor inhibitors (anti-VEGF),focal laser (FL),micropulse laser (SML),pan-retinal photocoagulation (PRP),and pars plana vitrectomy(PPV)

Results : The mean age of the patients was 67 years(33-97 years), 23 patients(42.59%) were female and 31(57.40%) were male, the duration of DME ranged between 2 and 9 years,(mean 2.8 years). Mean follow up before FAc was 41 months(2-96 months), mean follow up after FAc was 10 months(1-26).45 eyes(83.33%) were previously treated with dexamethasone intravitreal implant(DEXi), 14(25.9%) with sub-tenon’s triamcinolone acetonide(TAC), 39(72.22%) with anti-VEGF therapy, 10(18.5%) with SML, 10(18.5%) with FL, 18(33.33%) with PRP, and 10 (18.5%) with PPV +/- oil. Regarding anti-VEGF theray: 35 eyes (64.81%) were treated withwith bevacizumab, 3 eyes(5.55%) with ranibizumab,and 1 eye with aflibercept. At baseline the mean BCVA was 75.27 ETDRS letters(10-100),mean CMT was 326.321μm(276-377μm) and mean IOP was 15.2 mmHg (8-24). The final average BCVA was 83.57 ETDRS letters, CMT was 271.846μm (244-298μm), When comparing the eyes before FAC and after FAc injection, there was a mean of 8 letters of gain(P=0.011) in BCVA,a mean decrease of 54.884μm(P=0.003) in CMT, mean final IOP was 16.2 mmHg, 5 eyes required cataract surgery.

Conclusions : FAc represents a safe and effective alternative in the management of chronic DME, it is effective in improving BCVA and in decreasing CMT. Results from this real-life setting shows that FAc is a safe treatment modality with sustained results that can be safely offered to patients.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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