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Fadi alfaqawi, Ambreen Sarmad, Peck-Lin Lip, Samer Elsherbiny, Randhir Chavan, Arijit Mitra, Bushra Mushtaq; Three-year outcome of fluocinolone acetonide intravitreal implant (ILUVIEN) in the treatment of chronic diabetic macular oedema: real-world results in the UK. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4810. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
ILUVIEN implant is a slow release intravitreal steroid up to 36 months that has been approved by NICE to treat chronic DMO in pseudophakic eyes unresponsive to available therapies. We report the 3-year visual and anatomical outcomes of chronic DMO treated with ILUVIEN in a single tertiary referral centre.
Retrospective analysis of consecutive 22 eyes (18 patients) received ILUVIEN implant for refractory DMO. Standard assessment included visual acuity(VA), central retinal thickness(CRT), slit-lamp biomicroscopy and intraocular pressure(IOP) at year 1, 2 and 3.
Baseline mean VA in Early Treatment Diabetic Retinopathy Study (ETDRS) letters was 47(SD15) improved to 52(SD17) (P=0.251), 51(SD19) (P=0.343) and 49(SD18) letters (P=0.706) at year 1, 2 and 3 respectively. At 36-months VA improved in 10 eyes (45%), stabilized in 5 eyes (23%) and decreased in 7 eyes (32%). Five eyes (23%) gained >15 letters, 8 eyes (36%) gained >10 letters from baseline. Mean CRT decreased by 173µm from baseline 519µm(SD218) to 346µm(SD130) at 36-months (P=0.003). Twelve eyes (55%) received additional treatment in the form of anti-VEGF injection (9 eyes), macular laser (2 eyes), Ozurdex implant (2 eyes), most of rescue treatments were given in the 3rd year. Adverse events: raised IOP in 3 eyes (14%) controlled by IOP-lowering drops and selective laser trabeculoplasty, one stable treated endophthalmitis (VA=6/36 at year 3).
ILUVIEN implant is an effective long-term treatment option for chronic DMO with reduce injection rate in the first 3 years with low rate of raised-IOP adverse-effect. Longer and larger real-world data may provide a comprehensive long-term management strategy
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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