Abstract
Purpose :
Comparison of anatomical and functional outcomes with a single fluocinolone acetonide (0.19 mg FAc implant, ILUVIEN®) implant following suboptimal responses to ≤6 (early intervention) or > 6 prior intravitreal injections (IV) (late intervention).
Methods :
Retrospective analysis of 34 eyes with DME that persisted or recurred despite treatment. Eyes were divided into 2 groups: group A (n=21 eyes) receiving ≤6 prior IV (i.e. early intervention); and, group B (n=13 eyes) receiving >6 prior IV (i.e. late intervention). Best-corrected visual acuity (BCVA; reported in ETDRS letters throughout), central foveal thickness (CFT; measured using spectral domain OCT) and intraocular pressure (IOP; measured at month 1 and quarterly thereafter) were recorded at baseline and following therapy. The average follow-up in groups A and B were 32.7±4.5 and 32.1±4.8 months, respectively, and outcomes are reported at last observation.
Results :
The mean age of patients in group A was slightly higher than group B (70.4±6.8 vs. 67.6±9.5 years, respectively) and their mean DME duration was slightly shorter (3.3±0.8 vs. 3.7±1.5 years). All eyes had been treated with IV anti-VEGF (2.7±1.4 vs. 6.3±3.5 injections; group A vs. B) and short acting steroids (1.4±1.1 vs. 6.2±3.7). Following treatment with the FAc implant, significant (p < 0.05) improvements in BCVA were observed in both groups: in group A, BCVA increased by 18.3±13.3 letters from a baseline of 39.4±16.4 letters; and, in group B, BCVA increased by 10.2±13.7 letters from a baseline of 45.5±20.2 letters. In the majority eyes, BCVA was maintained/improved following therapy (i.e. 81.0% vs. 76.9%; group A vs. group B). The percentage of eyes gaining ≥15 letters and the overall reduction in CFT were numerically grater in group A (≥15 letters, 62.5% vs. 37.5% [group A vs. group B, respectively]; CFT, -234.2 µm vs. -182.1 µm). IOP remained stable over time in both groups.
Conclusions :
Early intervention with the FAc implant tended to favor improved functional and anatomical outcomes in the current analyses, suggesting the early detection of suboptimal responses to prior therapies is important in achieving the best outcomes for patients with persistent or recurrent DME.
This is a 2020 ARVO Annual Meeting abstract.