Optical Coherence Tomography Biomarkers - Vitreous Status Influence in Outcomes for Diabetic Macular Edema Therapy with 0.19 mg Fluocinolone Acetonide Implant
Background: The 0.19 mg fluocinolone acetonide (FAc) implant (ILUVIEN®; Alimera Sciences Ltd, Hampshire, UK) was approved for the treatment of vision impairment associated with chronic and refractory diabetic macular edema (DME). Objectives: To quantitatively assess functional and structural features in non-vitrectomized and vitrectomized DME patients after being treated with a FAc implant Methods: Retrospective review of patients with DME receiving single intravitreal injection of the FAc implant. The study was designed to analyze the presence of quantitative structural OCT biomarkers at baseline and 12 months after FAc therapy according to vitreous status. Results: A total of 41 eyes from 30 patients were included in this study. At 12 months post-injection, vitrectomized patients had a lower central foveal thickness (CFT, p=0.017) and fewer hyperreflective dots (HRD, p=0.028) compared with non-vitrectomized. Thirty (73%) patients presented a significant functional improvement with 17 (42%) increasing at least 15 ETDRS letters. Overall, 22 (54%) eyes had a complete resolution of DME at 12 months visit. Patients who needed additional therapy had a higher prevalence of subretinal fluid (SRF, 42% vs 3% p=0.005) at baseline. Conclusions: This study supports the effectiveness of the FAc implant and reports significant changes at 12 months post-FAc injection.