Real-World Outcomes in Diabetic Macular Edema for the 0.2 μg/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK

Abstract

Bushra Mushtaq,1 Ajay Bhatnagar,2 Helen Palmer3 1Birmingham Midland Eye Centre, City Hospital SWBH NHS Trust, Birmingham, UK; 2Department of Ophthalmology, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK; 3Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UKCorrespondence: Bushra MushtaqBirmingham Midland Eye Centre, City Hospital SWBH NHS Trust, Dudley Road, B18 7QH, UKTel [phone]Email [email protected]: To investigate real-world effectiveness and safety of fluocinolone acetonide (FAc) implant over three years of treatment in eyes with diabetic macular edema (DME) in a population with large ethnic diversity.Methods: This audit of three large treatment centres in the UK involved retrospective collection of outcome data (best recorded visual acuity [BRVA] by Early Treatment Diabetic Retinopathy Study [ETDRS] letters, central retinal thickness [CRT], intraocular pressure [IOP] and use of supplementary treatments) from patients with DME treated with 0.2 μg/day FAc intravitreal implant with three-year follow-up expected.Results: A total of 96 eyes were included. Ninety (93.8%) eyes had received prior intravitreal treatment. Increases in mean BRVA were significant at one, two and three years (p< 0.05). Overall, 78.1% of eyes gained or maintained BRVA; just over 50% gained ≥ 5 letters, representing a functional response. Eleven (11.6%) patients lost ≥ 10 letters by year three. Decreases in central retinal thickness (CRT) nearing 200 μm in the first year were sustained to three years (p < 0.0001). Patients with baseline VA ≥ 60 letters maintained their BRVA throughout follow-up, while significant improvements at month 12 (p< 0.0001) in those with baseline BRVA < 60 letters were maintained through month 36 (p < 0.005). Fifty-three (55.2%) eyes required no supplementary therapy during follow-up. Increases in IOP to ≥ 30 mmHg and ≥ 25 mmHg were seen in 12 (12.5%) and 23 (24.0%) eyes, respectively.Conclusion: This study confirms the effectiveness and tolerability of FAc implant up to 36 months in a real-world setting, highlighting the importance of early treatment for sustaining functional vision for patients.Keywords: fluocinolone acetonide, DME, diabetic macular edema, real-world, observational, case series

Keywords

• fluocinolone acetonide
• dme
• diabetic macular edema
• real-world
• observational
• case series.