PU Conference Series: Euretina 2018

Intravitreal Implants of Fluocinolone Leads to Marked Gains in Visual Acuity in Diabetic Macular Edema Long-acting steroid especially beneficial in patients with relatively good visual acuity at baseline.

B eneficial effects can be achieved with a long-acting steroid in patients with estab- lished persistent diabetic macular edema (DME), according to research. The findings sug- gest identifying patients with good visual acuity may be an effective strategy for optimizing patient outcomes. The use of the intravitreal fluocinolone acetonide implant known as ILUVIEN in patients with relatively good visual acuity (60 to 70 ETDRS letters) led to marked gains in visual acuity and central foveal thickness as well as a reversal of the progressive effects of not responding sufficiently to prior ther- apies, the researchers stated in their abstract. A retrospective cohort study of the clinical out- comes of ILUVIEN was undertaken and is currently ongoing in four ophthalmology centres in Portugal to evaluate the effectiveness of the fluocinolone acetonide implant in patients with persistent and recurrent DME.

“The study is unique as it allows DME progression to be monitored 12 months prior to and following ILUVIEN therapy,” the study authors noted in their abstract. “Given that patients treated with ILUVIEN would have experienced an inadequate response to prior therapies, we tested the hypothesis that switching from the current standard of care to ILUVIEN would lead to beneficial effects (stabili- zation or even an improvement) in terms of vision and retinal structure.” The study was presented by Angela Carneiro, MD, PhD, of the University of Porto in Portugal. Data were collected from 102 patients with DME. Patients were then included if they had records for the 12 months prior to ILUVIEN and at least two follow-up time points during the 12 months following ILUVIEN administration (ie, n=77 patients/113 patient eyes). A single ILUVIEN implant was administered at baseline (day zero). The mean age of patients was 68.4 ± 8.8 years (mean ± SD; range, 47 to 90), and there was a relatively even split between male and female patients (55% and 45%, respectively). Of the 77 patients enrolled, 34 (44.2%) were phakic at base- line, and on average DME patients waited 5.6 ± 3.3 years (range, 1.12 to 15.60) before the injection of an ILUVIEN implant.

" ...the ILUVIEN implant shows promise for treating diabetic macular edema and may be particularly helpful in patients with good initial visual acuity. " PRACTICEUPDATE CONFERENCE SERIES • EURETINA 2018 12