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Central retinal thickness improves with Iluvien implant in previously treated eyes
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BOSTON — Central retinal thickness values improved after exposure to fluocinolone acetonide implant in eyes previously treated for diabetic macular edema, according to a study.
However, steroid-induced ocular hypertension can occur despite a negative steroid challenge at baseline, with the baseline use of topical glaucoma therapy potentially confounding assessment of the steroid response, Sumit P. Shah, MD, FACS, said in a paper presentation at the American Society of Retina Specialists meeting.
Shah and colleagues undertook a retrospective chart review of 26 eyes of 20 patients receiving a single Iluvien intravitreal implant (0.19 mg fluocinolone acetonide, Alimera) after previous treatment for diabetic macular edema with a different therapy. Before implanting the fluocinolone acetonide agent, a steroid challenge was performed with dexamethasone implant in 25 of the eyes and with triamcinolone acetonide in one eye.
Mean IOP was reduced from 17.7 mm Hg at baseline to 15.7 mm Hg at 1 year (P = .02).
“Although this was statistically lower, this was confounded by the concurrent management of IOP increase in those patients developing ocular hypertension,” Shah said.
Differences in visual acuity between baseline (20/75) and 1-year follow-up (20/69) was not statistically significant, he said. There was a statistically significant difference in mean central retinal thickness, however, from 403.4 µm to 297.5 µm (P = .01).
“Despite the growing number of available treatments for DME, the treatment burden is high and there is a subset of patients that can be difficult to treat,” Shah said. – by Patricia Nale, ELS
Reference:
Shah SP, et al. One-year results of fluocinolone acetonide intravitreal implant for diabetic macular edema in highly treated eyes. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
Disclosure: Shah reports he is a consultant for Alimera Sciences, Genentech and Regeneron Pharmaceuticals.