Uveitis specialist treats macular edema with topical difluprednate

Issue: February 25, 2016

WAIKOLOA, Hawaii — One uveitis specialist has changed her practice and begun using topical difluprednate as an option for initial therapy for uveitic macular edema.

“There are a lot of different options for treating macular edema. We have drops, we have non-steroidal anti-inflammatory drops, we have steroids in many, many forms,” Nisha Acharya, MD, MS, said at Retina 2016. “We know steroids are very effective for both uveitis and for macular edema, but of course they come with known and expected side effects.”

Nishi Acharya

Often, treatment for uveitis will resolve the macular edema, Acharya said, but sometimes the macular edema persists and needs to be treated.

At her institute, the Proctor Foundation, Acharya uses difluprednate, which is approved for anterior ocular inflammation.

In data compiled at Proctor Foundation, Acharya and colleagues found that topical difluprednate resulted in a significant decrease in central macular thickness at 30 and 90 days, and about half of the patients studied had improvement in their macular edema, which was defined as a 20% reduction in macular thickness. About 25% to 30% had complete resolution at days 30 and 90 with dosing ranging up to four times a day. However, at 90 days, 25% of patients had experienced IOP of 24 mm Hg or more. Consequently, Acharya continues to follow up with these patients every 1 to 2 weeks to measure IOP.

“I would say consider a trial of this drop before you move on,” Acharya said. – by Patricia Nale, ELS

Reference:

Acharya N. Treatment of uveitic macular edema. Presented at: Retina 2016; Jan. 18-22, 2016; Waikoloa, Hawaii.

Disclosure: Acharya reports no relevant financial disclosures.