Optical Coherence Tomography Biomarkers: Vitreous Status Influence in Outcomes for Diabetic Macular Edema Therapy with 0.19-mg Fluocinolone Acetonide Implant

Ophthalmic Res. 2021;64(4):639-647. doi: 10.1159/000515306. Epub 2021 Mar 17.

Abstract

Background: The 0.19-mg fluocinolone acetonide (FAc) implant (ILUVIEN®; Alimera Sciences Ltd., Hampshire, UK) was approved for the treatment of vision impairment associated with chronic and refractory diabetic macular edema (DME).

Objectives: To quantitatively assess functional and structural features in nonvitrectomized and vitrectomized DME patients after being treated with an FAc implant.

Methods: Retrospective review of patients with DME receiving a single intravitreal injection of the FAc implant. The study was designed to analyze the presence of quantitative structural OCT biomarkers at baseline and 12 months after FAc therapy according to vitreous status.

Results: A total of 41 eyes from 30 patients were included in this study. At 12 months after injection, vitrectomized patients had a lower central foveal thickness (p = 0.017) and fewer hyperreflective dots (p = 0.028) compared with nonvitrectomized. Thirty (73%) patients presented a significant functional improvement with 17 (42%) increasing at least 15 ETDRS letters. Overall, 22 (54%) eyes had a complete resolution of DME at the 12-month visit. Patients who needed additional therapy had a higher prevalence of subretinal fluid (42 vs. 3%, p = 0.005) at baseline.

Conclusions: This study supports the effectiveness of the FAc implant and reports significant changes at 12 months after FAc injection.

Keywords: Biomarkers; Diabetic macular edema; Diabetic retinopathy; Fluocinolone acetonide; Vitrectomy.

MeSH terms

  • Biomarkers
  • Diabetes Mellitus
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Drug Implants
  • Fluocinolone Acetonide
  • Glucocorticoids
  • Humans
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity

Substances

  • Biomarkers
  • Drug Implants
  • Glucocorticoids
  • Fluocinolone Acetonide