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

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, Univer...

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Autores principales: Mushtaq B, Bhatnagar A, Palmer H
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:a953b7d4d1554637892f67b5c9855e192021-12-02T16:15:13ZReal-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK1177-5483https://doaj.org/article/a953b7d4d1554637892f67b5c9855e192021-07-01T00:00:00Zhttps://www.dovepress.com/real-world-outcomes-in-diabetic-macular-edema-for-the-02-gday-fluocino-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Bushra 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 +44 7976416571Email bushramushtaq@nhs.netAim: 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 seriesMushtaq BBhatnagar APalmer HDove Medical Pressarticlefluocinolone acetonidedmediabetic macular edemareal-worldobservationalcase series.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2935-2943 (2021)
institution DOAJ
collection DOAJ
language EN
topic fluocinolone acetonide
dme
diabetic macular edema
real-world
observational
case series.
Ophthalmology
RE1-994
spellingShingle fluocinolone acetonide
dme
diabetic macular edema
real-world
observational
case series.
Ophthalmology
RE1-994
Mushtaq B
Bhatnagar A
Palmer H
Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
description 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 +44 7976416571Email bushramushtaq@nhs.netAim: 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
format article
author Mushtaq B
Bhatnagar A
Palmer H
author_facet Mushtaq B
Bhatnagar A
Palmer H
author_sort Mushtaq B
title Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
title_short Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
title_full Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
title_fullStr Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
title_full_unstemmed Real-World Outcomes in Diabetic Macular Edema for the 0.2 &mu;g/Day Fluocinolone Acetonide Implant: Case Series from the Midlands, UK
title_sort real-world outcomes in diabetic macular edema for the 0.2 &mu;g/day fluocinolone acetonide implant: case series from the midlands, uk
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/a953b7d4d1554637892f67b5c9855e19
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