Purchase this article with an account.
Ahmed Elbarky; Rapid structural and functional improvements following 0.19 mg fluocinolone acetonide (FAc) implant in diabetic macular edema patients with poor visual acuity: 6-month audit results from The United Arab Emirates.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1905.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The Abu Dhabi Health Authority approved the reimbursement of the slow release FAc implant (ILUVIEN) in October 2016 and it is now available for the treatment of diabetic macular edema (DME) in persons who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in intraocular pressure. We performed a retrospective 6-month audit to assess the efficacy and safety of the FAc implant in our clinical practice.
Twenty patients with pseudophakic lenses, treated with ILUVIEN, were investigated to evaluate functional and anatomical characteristics and outcomes (visual acuity [VA; ETDRS letters score], central macular thickness [CMT] and intraocular pressure [IOP]) at baseline, weeks 2-4 and months 3 and 6.
All patients had been treated with a prior corticosteroid (n=5, dexamethasone implant; n=15, prednisolone acetate 4-times per day for 4 weeks prior to ILUVIEN). Mean baseline VA was 38±3 letters (median value was 35; range, 20 to 55) at baseline (see Figure). After ILUVIEN, mean VA rapidly improved by +13±1 letters (mean+SD) after 2-4 weeks and improved further by months 3 and 6 (+26±2 and +29±2 letters, respectively). Between 2 and 4 weeks, 14/20 patients achieved a ≥15 letters and all had achieved ≥15 letters by month 6. The changes in VA were accompanied by rapid and marked improvements in CMT, from a baseline of 519±17 µm, with mean reductions of -158±10 µm, -239±17 µm and -256±18 µm at weeks 2-4, month 3 and month 6, respectively. At baseline CMT was >350 µm in all cases and was £350 µm (dry macula) in 13/20 patients by weeks 2 to 4 and in 19/20 patients at month 6. Emergent IOP was being managed with drops in three patients (15%) and none required IOP-lowering surgery (0%).
In patients with poor VA that had predominantly been treated with a prior course of steroid drops, ILUVIEN led to rapid improvements in VA and CMT with 100% of patients experiencing 3 or more lines of improved visual acuity by month 6 and 95% achieving sustained drying of the macula.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Absolute values for VA, CMT and IOP up to month 6
This PDF is available to Subscribers Only