Use of flucinolone acetonide for patients with diabetic macular oedema: patient selection criteria and early outcomes in real world setting.
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Authors
Andreatta, Walter
Bhatnagar, Ajay
Elaraoud, Ibrahim
Yang, Yit
Issue Date
2016-01-05
Journal
Type
Article
Peer-Reviewed Publication
Peer-Reviewed Publication
Keywords
Adult
Aged
Central retinal thickness
Diabetic macular edema
Diabetes mellitus
Diabetic retinopathy
Drug implants
Female
Fluocinolone acetonide
Glucocorticoids
Iluvien
Macular edema
Male
Middle aged
Multicentre study
Patient selection
Peer-reviewed article
Retina
Retrospective study
Treatment outcome
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Visual acuity
Aged
Central retinal thickness
Diabetic macular edema
Diabetes mellitus
Diabetic retinopathy
Drug implants
Female
Fluocinolone acetonide
Glucocorticoids
Iluvien
Macular edema
Male
Middle aged
Multicentre study
Patient selection
Peer-reviewed article
Retina
Retrospective study
Treatment outcome
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Visual acuity
Journal Title
BMC Ophthalmology
Volume
16
Issue
3
Begin page
End page
Abstract
Introduction: Fluocinolone acetonide slow release implant (Iluvien®) was approved in December 2013 in UK for treatment of eyes which are pseudophakic with DMO that is unresponsive to other available therapies. This approval was based on evidence from FAME trials which were conducted at a time when ranibizumab was not available. There is a paucity of data on implementation of guidance on selecting patients for this treatment modality and also on the real world outcome of fluocinolone therapy especially in those patients that have been unresponsive to ranibizumab therapy.
Method: Retrospective study of consecutive patients treated with fluocinolone between January and August 2014 at three sites were included to evaluate selection criteria used, baseline characteristics and clinical outcomes at 3-month time point.
Results: Twenty two pseudophakic eyes of 22 consecutive patients were included. Majority of patients had prior therapy with multiple intravitreal anti-VEGF injections. Four eyes had controlled glaucoma. At baseline mean VA and CRT were 50.7 letters and 631 μm respectively. After 3 months, 18 patients had improved CRT of which 15 of them also had improved VA. No adverse effects were noted. One additional patient required IOP lowering medication. Despite being unresponsive to multiple prior therapies including laser and anti-VEGF injections, switching to fluocinolone achieved treatment benefit.
Conclusion: The patient level selection criteria proposed by NICE guidance on fluocinolone appeared to be implemented. This data from this study provides new evidence on early outcomes following fluocinolone therapy in eyes with DMO which had not responded to laser and other intravitreal agents.
Citation
Elaraoud I, Andreatta W, Kidess A, Bhatnagar A, Tsaloumas M, Quhill F, Yang Y. Use of flucinolone acetonide for patients with diabetic macular oedema: patient selection criteria and early outcomes in real world setting. BMC Ophthalmol. 2016 Jan 5;16:3. doi: 10.1186/s12886-015-0178-9. PMID: 26728265; PMCID: PMC4700741.