Abstract
Purpose :
To evaluate the effective duration of Fluocinolone acetonide (FAc) implant (ILUVIEN®) in diabetic macular edema.
Methods :
Retrospective study of 25 patients, involving 35 eyes, from October 2016 to August 2022. This study was conducted in the Department of Ophthalmology at the University of Florida. Patient’s data included the indications for the FAc implant, visual acuity, intraocular pressure (IOP), optical coherence tomography (OCT) macular thickness, the time interval for further anti-VEGF intravitreal injections, and related side effects.
Results :
The mean visual acuity before and after the FAc implant treatment was 20/111.68 (logMAR 0.75) and 20/78.14 (logMAR 0.59) (p=0.49864982), respectively. The mean intraocular pressure before and after treatment was 15.22 mm Hg and 16.91 mm Hg, respectively (p=0.122). The mean OCT macular thickness before and after the administration of the FAc implant, 1-3 months, 4-6 months, 7-9 months, and more than 9 months and before the initiation of further intravitreal injections was 490.41, 438.71, 551.68, 405.69, 508.67, and 489.14 μm, respectively. The mean number of eyes requiring a reinitiating of anti-VEGF of intravitreal injections was 24 eyes (68.6%). The remaining patients (31.4%) either had improved DME (22.9%) or refused intravitreal injections (2.9%) or stopped coming into the clinic (5.7%). The time duration between the FAc implant treatment and the reinitiating of intravitreal injection was approximately 275.3 days. In addition, 16 eyes (45.7%) needed IOP lowering drops. Ten eyes (28.6%) experienced continuing troublesome floaters.
Conclusions :
In our study, the mean duration of effectiveness of the FAc implant treatment before subsequent intravitreal injection therapy was 275.3 days or 9.05 months, which is shy of the 36 months for which it is meant to be effective. The FAc implant treatment resulted in a marginal improvement in visual acuity and decrease in mean OCT macular thickness. However, significant number of patients did experience side effects and approximately 66% of eyes needed regular intravitreal injection therapy. Therefore, FAc implant treatment can be used to treat diabetic macular edema but considering its cost and effective duration of 9 months in our study, it may not be an effective choice of treatment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.