Real-world experience: Positive DME treatment outcomes observed with FAc implant at UK centre

Take-home message: Dr Mushtaq discusses one centre’s initial post-marketing experience with the fluocinolone acetonide intravitreal implant 0.19 mg. The implant demonstrated favourable outcomes and good patient acceptance.

 

By Cheryl Guttman Krader, Reviewed by Dr Bushra Mushtaq, FRCS

Initial post-marketing experience with the fluocinolone acetonide intravitreal implant 0.19 mg (Iluvien, Alimera Sciences, Hampshire, UK) indicates it is a valuable addition for the treatment of diabetic macular edema (DME).

Study details

Over a period of about 9 months, the implant has been used to treat DME in 23 eyes of 18 patients presenting to the medical retina department at Birmingham and Midlands Eye Centre, Birmingham, UK.

Case study: FAc implant found to provide effective long-term therapy

“All patients had failed prior therapy and had very chronic, advanced macular changes associated with DME duration of 2 to 7 years,” said Dr Mushtaq.

Follow-up examinations, which ranged from 1 week to 9 months, showed a mean subfoveal thickness decrease from 513 μm pre-implantation to 376 μm post-implantation. Near complete drying of the macula was achieved in 11 eyes. Six eyes still had significant DME, but follow-up was still relatively early for some of those cases (range, 5 days to 2 months). Visual acuity (VA) improved as well in most eyes that were followed for 6 weeks or longer, with some eyes gaining up to 4 Snellen lines. Only 3 eyes had no improvement on optical coherence tomography (OCT) or in VA.

“The 3 eyes that did not achieve flattening of the macula had very chronic DME and had failed prior treatment with laser, anti-VEGF injections, and even intravitreal tri-amcinolone,” Dr Mushtaq said. “However, even these eyes exhibited some benefit from the fluocinolone implant as patients noted improvement in quality of vision.”

“Moreover, all of the patients have been very happy because of the fact that the long-acting fluocinolone implant allows for a reduced visit burden,” she said.

Topical treatment warning for orbital soft tissue

Instead of having to return for treatment monthly, patients who receive the fluocinolone acetonide implant are scheduled for follow-up visits every 3 months after initially being seen at 1 to 2 weeks and then 6 to 8 weeks post-implantation, explained Dr Mushtaq.

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