scholarly journals Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapie

2019 ◽  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Options ◽  
Current Understanding ◽  
Pharmacologic Treatment

scholarly journals Diabetic Macular Edema Outcomes in Eyes Treated with Fluocinolone Acetonide 0.2 µg/d Intravitreal Implant: Real-World UK Experience

2017 ◽  
Vol 27 (3) ◽  
pp. 357-362 ◽  
Author(s):  
Ibraheem El-Ghrably ◽  
David H.W. Steel ◽  
Maged Habib ◽  
Daniela Vaideanu-Collins ◽  
Sridhar Manvikar ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Real World ◽  
Safety Profile ◽  
Treatment Options ◽  
Fluocinolone Acetonide ◽  
Efficacy And Safety ◽  
Large Hospital ◽  
The United Kingdom ◽  
Intravitreal Implant

Purpose To conduct an observational, multicenter study to evaluate real-world clinical efficacy and safety of the 0.2 µg/day fluocinolone acetonide (FAc) implant in the treatment of patients with chronic diabetic macular edema (DME) in 3 large hospital ophthalmology departments in the United Kingdom. Methods Fluocinolone acetonide implants were inserted into the study eyes following a suitable washout period; phakic eyes received FAc implant following cataract surgery. Follow-up visits took place 2-4 weeks postinjection and then at 3, 6, and 12 months; change in central macular thickness (CMT) from baseline was measured by optical coherence tomography and best-corrected visual acuity (BCVA) was also assessed. Adverse events and changes in intraocular pressure (IOP) were recorded in order to evaluate the safety profile for the FAc implant. Results Improvements in BCVA and CMT were observed from 3 months and sustained for the duration of observation. At 12 months, the overall mean change from baseline CMT was -126 μm and mean increase in BCVA from baseline was 5.1 letters. Increases in IOP following FAc implant were easily managed with IOP-lowering medication. Implant migration into the anterior chamber occurred in 2 eyes where prior vitrectomy had resulted in a posterior capsule defect; this was rectified and resolved. Conclusions The results of this study provide further efficacy and safety profile data for FAc implant treatment of chronic DME in a real-world clinical setting; the FAc implant appears to be a valuable therapeutic approach for patients with chronic DME who have suboptimal response to other treatment options.

scholarly journals The Evolving Treatment Options for Diabetic Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Atul Jain ◽  
Neeta Varshney ◽  
Colin Smith
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Treatment Options ◽  
Previous Treatment ◽  
Common Cause ◽  
Working Age

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME.

Treatment Options for Diffuse Diabetic Macular Edema

2011 ◽  
Vol 21 (6_suppl) ◽  
pp. 45-50 ◽  
Author(s):  
Francesco Bandello ◽  
Pierluigi Iacono ◽  
Mauhzio Battaglia Parodi
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Options ◽  
Diffuse Diabetic Macular Edema

Pharmacologic Treatment in Diabetic Macular Edema

2006 ◽  
pp. 291-300
Author(s):  
Zeshan A. Rana ◽  
P. Andrew Pearson
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Pharmacologic Treatment

Long-term Therapies for Diabetic Macular Edema

2012 ◽  
Vol 06 (04) ◽  
pp. 236 ◽  
Author(s):  
Andrew J Lotery ◽  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Safety Profile ◽  
Treatment Options ◽  
Fluocinolone Acetonide ◽  
Diabetic Patients ◽  
Sustained Drug Release ◽  
Improved Outcomes ◽  
Intravitreal Implant ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) is one of the main causes of visual loss in diabetic patients. Although photocoagulation and intensive control of systemic metabolic factors have achieved improved outcomes, improvement is slow and some patients with DME continue to lose vision despite treatment. Pharmacological treatment options for DME include vascular endothelial growth factor (VEGF) antagonists such as ranibizumab, bevacizumab and pegaptanib and corticosteroids, whose multiple mechanisms of action include reduction of VEGF expression. Intravitreal delivery of these agents has shown efficacy in the treatment of DME but is associated with adverse effects including cataract progression and sustained rises in intraocular pressure. The physical characteristics and potent anti-inflammatory properties of fluocinolone acetonide (FAc) have led to its use in intravitreal implants. A number of intravitreal implants have been evaluated, of which the most effective at providing sustained drug release with an acceptable safety profile is the ILUVIEN® implant. This FAc intravitreal implant provides significant, long-lasting improvements in visual acuity for patients with chronic DME and has a manageable safety profile.

scholarly journals Update on the Management of Diabetic Macular Edema

2017 ◽  
Vol 10 (01) ◽  
pp. 52
Author(s):  
Shawn M Iverson ◽  
W Lloyd Clark ◽  
◽  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Clinical Practices ◽  
Working Age ◽  
Endothelial Growth Factor ◽  
Review Current

Diabetic macular edema (DME) is a treatable sequela of diabetic retinopathy and a significant cause of visual morbidity among working age individuals worldwide. While anti-vascular endothelial growth factor (anti-VEGF) agents are first-line agents in the management of DME, corticosteroids and laser therapy can play a role as well. Despite a growing understanding of best clinical practices, many patients respond unpredictably to therapy. This article will briefly review current treatment modalities and discuss future treatment options for managing DME.

scholarly journals Guidelines for the Management of Center-Involving Diabetic Macular Edema: Treatment Options and Patient Monitorization

2021 ◽  
Vol Volume 15 ◽  
pp. 3221-3230
Author(s):  
João Figueira ◽  
José Henriques ◽  
Ângela Carneiro ◽  
Carlos Marques-Neves ◽  
Rita Flores ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Options

scholarly journals Managing Diabetic Macular Edema in Clinical Practice: Systematic Review and Meta-Analysis of Current Strategies and Treatment Options

2021 ◽  
Vol Volume 15 ◽  
pp. 375-385
Author(s):  
Daniele Veritti ◽  
Valentina Sarao ◽  
Valentina Soppelsa ◽  
Paolo Lanzetta
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Meta Analysis ◽  
Treatment Options

PP084 Diabetic Macular Edema: A Comparison Between Treatment Options

2017 ◽  
Vol 33 (S1) ◽  
pp. 109-110 ◽  
Author(s):  
Lucrezia Ferrario ◽  
Emanuela Foglia ◽  
Francesco Bandello ◽  
Camilla Ferri ◽  
Innocente Figini ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Technology Assessment ◽  
Treatment Options ◽  
Health Technology ◽  
P Value ◽  
Lombardy Region ◽  
Data Matching ◽  
Italian Regions

INTRODUCTION:Health Technology Assessment (HTA) aims at providing decision makers with relevant data, matching different perspectives, with an evidence-based approach. The most common framework used is the European Network for Health Technology Assessment (EUnetHTA) Core Model (1): HTA may be further supported by a Multi-Criteria Decision Analysis (MCDA) (2,3), leading to a final quantitative synthesis, facilitating the appraisal phase.This project presents a multi-dimensional comparison of the technologies available for the treatment of diabetic macular edema (Ranibizumab, Aflibercept, Dexamethasone implant and off-label Bevacizumab), comparing three Italian Regions: Lombardy, Liguria and Veneto.METHODS:The nine EUnetHTA dimensions were first prioritized by seventeen multidisciplinary evaluators. Thereafter a further nine professionals attributed a 3-level rating score (from “1” not performant, to “3” most performant) to each dimension and sub-dimension, after carefully assessing the three HTA reports. In conclusion, the investigation of statistically significant differences between the attributed scores of the evaluators was conducted, using a multi-variate analysis.RESULTS:No statistically significant differences were reported in the prioritization of each dimension, except for the equity (more important in Liguria and in Lombardy) and the economic financial dimensions (more relevant in Veneto and in Lombardy).Notwithstanding the evaluators’ different professional titles, job roles, center size, and various Regional contexts, they attributed similar scores to the HTA dimensions during the appraisal phase (even though conducted in different years, in 2015 and 2016). This finding demonstrates the robustness of both the evaluations and the final MCDA results: i) no statistically inter-regional significant differences emerged regarding Ranibizumab and Aflibercept (p-value >.05); ii) no statistically significant inter-regional differences emerged regarding Dexamethasone, except for the assessments in the clinical dimensions (p-value = .026), since in Lombardy Region the evaluation was carried out earlier in the technology's life-cycle.CONCLUSIONS:Dexamethasone was consistently attributed a higher total score, considering the final normalised weight derived from the MCDA approach (p-value =.001).

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