In:
Ophthalmic Research, S. Karger AG, Vol. 63, No. 2 ( 2020), p. 114-121
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 First-line treatment for diabetic macular edema (DME) is usually with antivascular endothelial growth factor agents, followed by intravitreal corticosteroids as a second-line treatment option. Long-term corticosteroids may offer quality of life and effectiveness benefits over short-term implants. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 To evaluate outcomes of patients with persistent or recurrent DME who switched from a short-term (dexamethasone) to a long-term (fluocinolone acetonide, FAc) corticosteroid intravitreal implant in a real-world setting. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This is a retrospective study in 9 Portuguese centers. An FAc intravitreal implant was administered according to product labeling. Effectiveness outcomes were mean change in visual acuity (VA; ETDRS letters), central retinal thickness (CRT; µm), and macular volume (MV; mm 〈 sup 〉 3 〈 /sup 〉 ). The safety outcome was mean change in intraocular pressure (IOP; mm Hg). All were analyzed at months 1 and 3, and then quarterly until month 24 after implantation. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Forty-four eyes from 36 patients were analyzed. Mean duration of DME was 3.3 ± 1.9 years, and mean follow-up was 8 months. From baseline following FAc implantation, VA increased significantly at months 1 and 6 (mean +6.82 and +13.02 letters, respectively; 〈 i 〉 p 〈 /i 〉 = 0.005), and last observation carried forward (LOCF; mean +8.3 letters; 〈 i 〉 p 〈 /i 〉 = 0.002). CRT improved significantly at months 1 and 6 (mean –71.81 and –170.77 µm, respectively; 〈 i 〉 p 〈 /i 〉 = 0.001), and LOCF (mean –121.46 µm; 〈 i 〉 p 〈 /i 〉 = 0.001). MV was consistently, but not significantly, decreased from baseline to LOCF (mean –0.69 mm 〈 sup 〉 3 〈 /sup 〉 ; 〈 i 〉 p 〈 /i 〉 = 0.062). The mean change in IOP was –0.25 and +0.88 mm Hg at months 1 and 6, respectively ( 〈 i 〉 p 〈 /i 〉 = 0.268), and +1.86 mm Hg at LOCF ( 〈 i 〉 p 〈 /i 〉 = 0.036). Increases were controlled with topical medication in most cases. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The FAc intravitreal implant is effective in patients previously treated with short-term corticosteroid implants. Thus, after a suboptimal response to antiangiogenics or a short-term corticosteroid, a single FAc implant may be considered an effective and tolerable treatment that can improve long-term outcomes for patients with sight-threatening DME.
Type of Medium:
Online Resource
ISSN:
0030-3747
,
1423-0259
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
1483177-6
Permalink