Injectable 0.19-mg fluocinolone acetonide intravitreal implant for the treatment of non-infectious uveitic macular edema

The efficacy of the 0.19-mg fluocinolone acetonide (FAc) intravitreal implant (ILUVIEN) in the treatment of non-infectious uveitic macular edema (UME) was assessed on twenty-six patients (34 eyes) with non-infectious UME between 2013 and 2020, in a mean follow-up of 18 ± 19.3 (mean ± SD) months. Macular edema was resolved in 24 (70.6%) cases. Five of these eyes had a relapse after 23.2 ± 14 months. Three FAc reinjections were performed and a drying of the macula was observed. After FAc implantation, 24 eyes (70.6%) were completely dry; central retinal thickness (CRT) decreased in 6 eyes (17.6%), but residual intraretinal fluid was still evident. In 20 eyes (58.5%), visual acuity (VA) improved (from +1 to +5 lines) and remained stable in 9 eyes (26.5%). Thirty eyes (88.2%) were pseudophakic at baseline and four were phakic. Three of these eyes had a cataract prior to therapy and the other developed a cataract 2.5 years after the FAc implant was administered. There was an overall increase in intraocular pressure (IOP; +4.4 ± 3.7 mmHg) and eye drops were required in three eyes. The FAc implant led to long-term improvements in mean CRT and VA, and that the side-effect profile was manageable in a clinical setting in patients with non-infectious UME.

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Fluocinolone acetonide intravitreal implant for the treatment of diabetic macular edema

Drug Design Development and Therapy ◽

10.2147/dddt.s44427 ◽

2013 ◽

pp. 425 ◽

Cited By ~ 1

Author(s):

Christine Flaxel ◽

Beardsley ◽

Messenger

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Fluocinolone Acetonide ◽

Intravitreal Implant ◽

Fluocinolone Acetonide Intravitreal Implant

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Outcomes in diabetic macular edema switched directly or after a dexamethasone implant to a fluocinolone acetonide intravitreal implant following anti-VEGF treatment

Acta Diabetologica ◽

10.1007/s00592-019-01439-x ◽

2019 ◽

Vol 57 (4) ◽

pp. 469-478 ◽

Cited By ~ 6

Author(s):

Matus Rehak ◽

Catharina Busch ◽

Jan-Darius Unterlauft ◽

Claudia Jochmann ◽

Peter Wiedemann

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Fluocinolone Acetonide ◽

Anti Vegf ◽

Intravitreal Implant ◽

Group A ◽

Stopping Treatment ◽

Cataract Development ◽

Group B ◽

Fluocinolone Acetonide Intravitreal Implant

Abstract Aims Fluocinolone acetonide (FAc) is an intravitreal corticosteroid implant approved for the second-line treatment of diabetic macular edema (DME). This study compared outcomes of patients with DME switched directly to an FAc implant, versus indirectly via dexamethasone, after anti-VEGF therapy failure. Methods This is a retrospective, single-center chart review. Patients were assigned to Group A (switched to FAc after anti-VEGF) or Group B (switched to dexamethasone and then to FAc after > 4 months). Charts were reviewed for best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and cataract development. Results Forty-nine eyes were included. BCVA increased and CMT decreased with anti-VEGF (both groups), and dexamethasone (Group B only), but regressed after stopping treatment. With FAc, BCVA increased rapidly and significantly: increases were maintained up to 36 months (P < 0.001), except at 18 and 9 months in Groups A and B, respectively. Significant CMT reductions (P < 0.001) were evident after 3 months and maintained up to 36 months in both groups. IOP increase > 21 mmHg occurred in 14 patients (nine in Group A, five in Group B): all were sufficiently treated with IOP-lowering drops. Nineteen phakic eyes (73.1%) developed cataract: seven underwent phaco-emulsification (two in Group A, five in Group B). Conclusions Similar functional and anatomical improvements occurred in FAc-treated eyes, regardless of whether they first received dexamethasone or switched directly to FAc after anti-VEGF. Safety signals were consistent with corticosteroid class effects. Early switch to FAc could benefit patients who respond insufficiently to anti-VEGF.

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Recurrent Diabetic Macular Edema: What to Do

Case Reports in Ophthalmology ◽

10.1159/000480119 ◽

2017 ◽

Vol 8 (3) ◽

pp. 465-474 ◽

Cited By ~ 2

Author(s):

Rita Santos Gonçalves ◽

Carla Teixeira ◽

Pedro Coelho

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Fluocinolone Acetonide ◽

Macular Thickness ◽

Central Macular Thickness ◽

Effective Treatment Option ◽

Intravitreal Implant ◽

Surgical Treatments ◽

Fluocinolone Acetonide Intravitreal Implant

Diabetic macular edema (DME) is a leading cause of blindness in the working population. Herein, we report the case of a patient with recurrent DME for about 6 years, uncontrolled by several medical and surgical treatments, that was successfully treated with a single sustained-release fluocinolone acetonide intravitreal implant in her right eye. The affected eye had presented a visual acuity of 2/10 and a central macular thickness of 488 µm prior to the injection. After treatment with the fluocinolone acetonide intravitreal implant, the patient’s right eye presented an improvement in best corrected visual acuity to 6/10 and a reduction of central macular thickness to 198 µm. These functional and anatomical results were continuous and sustained during a follow-up period of more than 12 months, and with an acceptable and manageable safety profile. These results show that fluocinolone acetonide intravitreal implantation is an effective treatment option in DME and should be considered in the DME treatment pathway.

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