July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Reduction in treatment burden and edema in patients with diabetic macula edema following 0.2mg/day fluocinolone acetonide implant.
Author Affiliations & Notes
  • Clinton Ellingson
    Retina Associates of Kentucky, Lexington, Kentucky, United States
    Ophthalmology, University of Kentucky, Lexington, Kentucky, United States
  • John William Kitchens
    Retina Associates of Kentucky, Lexington, Kentucky, United States
  • Thomas W Stone
    Retina Associates of Kentucky, Lexington, Kentucky, United States
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4813. doi:
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    • Get Citation

      Clinton Ellingson, John William Kitchens, Thomas W Stone; Reduction in treatment burden and edema in patients with diabetic macula edema following 0.2mg/day fluocinolone acetonide implant.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4813.

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

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Abstract

Purpose : Fluocinolone acetonide (FAc) implants are approved to treat diabetic macular edema (DME), as established in the FAME trials, which showed efficacy up to 36 months. In the current setting of multiple treatment options for DME, it is unclear how to integrate the use of FAc in the clinical setting. This study is a retrospective review on the impact of FAc as a long acting steroid for the treatment of DME in a private practice setting. The primary outcome is the number of subsequent treatments following the administration of FAc. Secondary outcomes include the pre- FAc treatment to post treatment comparison of best corrected visual acuity (BCVA), central foveal thickness (CFT) as measured by spectral domain ocular coherence tomography (SD-OCT), as well as intraocular pressure (IOP).

Methods : A retrospective chart review with IRB approval, of all patients treated with FAc implant at a single private practice with eight retina specialists over a two year period. The number of treatments received for DME before and after FAc implants was collected, as was BCVA, CFT, and IOP.

Results : A total of 24 eyes in 17 patients were treated with FAc implant during a 2 year period. 7 eyes of 5 patients were excluded due lack of follow up. Average follow up time was 26 months. Treatment burden was reduced from an average of 4.1 injections pre-implant to 1.4 post-FAc implant. 82% showed a decrease in treatment burden. 35% required no additional treatment after initial FAc implant. At the last recorded visit, mean reduction of CFT was 173.9┬Ám (p=0.007); 65% had 20/40 or better BCVA and 25% had at least 15 letters improvement. In one patient, an additional IOP lowering medication was started. No IOP lowering surgeries occurred.

Conclusions : Long acting steroid implant is a suitable treatment option for DME. This study demonstrates that integrating long acting steroids into the treatment strategy for DME led to a reduction in the treatment frequency. The implant also led to significant improvement in retinal thickness, stable visual acuity, and no major safety issues regarding IOP. It often worked most effectively with periodic anti-VEGF therapy.

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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