July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Second-Line Treatment with Iluvien for persistent pre-treated Diabetic Macular Edema
Author Affiliations & Notes
  • Michael Ulbig
    Technical University Munich, Munich, Germany
  • Klaus Wehrmann
    Technical University Munich, Munich, Germany
  • Mathias Maier
    Technical University Munich, Munich, Germany
  • Footnotes
    Commercial Relationships   Michael Ulbig, Alimera (C), Allergan (F), Bayer (F), MSD (F), Novartis (F); Klaus Wehrmann, None; Mathias Maier, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1898. doi:
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    • Get Citation

      Michael Ulbig, Klaus Wehrmann, Mathias Maier; Second-Line Treatment with Iluvien for persistent pre-treated Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1898.

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

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Abstract

Purpose : We included 20 Iluvien treated eyes. Persistent DME was defined as pre-treated with intra-vitreal Anti-VEGF drugs, a dexamethasone implant, and/or focal laser and insufficient gain in visual acuity (VA) and persistent intra-retinal fluid on optical coherence tomography (OCT). On average, eyes had 7 previous intra-vitreal Anti-VEGF injections or at least 2 Dexamethasone implants over the previous 12 months. A majority had deferred laser too. SD-OCT scans were performed prior to the Fluocinolone Acetonide implant. Follow-up scans were acquired at 1 month, 3 months, and 1 year. Adverse events, such as cataract or elevated intra-ocular pressure (IOP) were registered. OCT scans were evaluated for central retinal thickness (CRT) and small dense particles (SDP). Clinical examination was performed at all visits including VA, IOP, and stereoscopic bio-microscopy.

Methods : Mean CRT before Iluvien was 311 microns, SDP were found in 12 out of 20 eyes, and mean VA was 6/20. Following Iluvien injection, mean CRT decreased to 287 microns at 1 month, and 285 microns at 3 months. Mean VA improved to 8/20. SDP vanished in 8 eyes. After one year, thirteen eyes were re-examined and mean CRT was 273 microns. Mean VA remained stable at 8/20. Eight eyes were phacic, 6 of those developed cataract. Two patients had an increased IOP which was controlled with eye drops. Cataract surgery with Iluvien in the eye was possible with maintaining a stable macular situation.

Results : Mean CRT before Iluvien was 311 microns, SDP were found in 12 out of 20 eyes, and mean VA was 6/20. Following Iluvien injection, mean CRT decreased to 287 microns at 1 month, and 285 microns at 3 months. Mean VA improved to 8/20. SDP vanished in 8 eyes. After one year, thirteen eyes were re-examined and mean CRT was 273 microns. Mean VA remained stable at 8/20. Eight eyes were phacic, 6 of those developed cataract. Two patients had an increased IOP which was controlled with eye drops. Cataract surgery with Iluvien in the eye was possible with maintaining a stable macular situation.

Conclusions : Iluvien is a viable option for pre-treated persistent DME. Finally CRT was almost within normal range. SDP regressed in most eyes. IOP elevation was controlled with eye drops. Cataract surgery did not lead to recurrence of DME.

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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