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Ramin Khoramnia, Lea Weber, Stefanie Marx, Alexander Scheuerle, Gerd Auffarth; Injectable 0.19 mg fluocinolone acetonide (FAc) intravitreal implant for the treatment of non-infectious uveitic macular edema – a retrospective case study analysis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):419.
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The injectable 0.19 mg fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN; Alimera Science Inc., Alpharetta, USA) allows sustained release of 0.2 µg of FAc per day for up to 3 years and has been shown to be efficacious in randomized clinical trials in patients with diabetic macular edema. In this retrospective observational clinical study we report the early safety and effectiveness outcomes following the off-label use of the implant in the treatment of non-infectious uveitic macular edema.
Data are presented from 8 patients (11 eyes) with non-infectious uveitic macular edema who were treated with a 0.19 mg FAc implant. 9/11 eyes were pseudophakic prior to implantation of the FAc implant and both phakic eyes required a cataract operation during the follow-up period (the median follow-up was 19 months; range, 8-42 months). The main outcome measures were changes in: central retinal thickness (CRT; measured using spectral domain optical coherence tomography); corrected distance visual acuity (VA); uveitic activity; and, intraocular pressure (IOP).
In 11/11 eyes CRT improved by months 1 to 3 (Figure 1). The mean maximum decrease of CRT throughout the follow-up period was 168±202 µm (±SD). 9/11 eyes showed an improvement in VA (between 1 and 8 lines, Figure 2) and 2/11 eyes lost VA (1 and 3 lines, respectively). 9/11 eyes presented with inactive inflammation during the follow-up period and in 1/11 eyes there was a relapse at month 42. 4/11 eyes presented with a relapse of macular edema between months 3 and 8. The mean increase in IOP was 2.1±4.7 mmHg.
In this small case series, treatment of non-infectious uveitic macular edema with the injectable FAc implant was associated with improved CRT and VA, and a manageable safety profile. The advantage of this device is the long-term drug release and the fact that it can be injected into the vitreous in a short procedure in contrast to other treatment options.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Development of mean CRT 6, 12, 24 and 36 months after the treatment with the injectable fluocinolone acetonide intravitreal implant (0.19 mg)
Development of mean visual acuity 6, 12, 24 and 36 months after the treatment with the injectable fluocinolone acetonide intravitreal implant
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