Use of flucinolone acetonide for patients with diabetic macular oedema

patient selection criteria and early outcomes in real world setting

Ibrahim Elaraoud, Walter Andreatta, Andrej Kidess, Ajay Bhatnagar, Marie Tsaloumas, Fahad Quhill, Yit Yang

Research output: Contribution to journalArticle

Abstract

Introduction: Fluocinolone acetonide slow release implant (Iluvien®) was approved in December 2013 in UK for treatment of eyes which are pseudophakic with DMO that is unresponsive to other available therapies. This approval was based on evidence from FAME trials which were conducted at a time when ranibizumab was not available. There is a paucity of data on implementation of guidance on selecting patients for this treatment modality and also on the real world outcome of fluocinolone therapy especially in those patients that have been unresponsive to ranibizumab therapy. Method: Retrospective study of consecutive patients treated with fluocinolone between January and August 2014 at three sites were included to evaluate selection criteria used, baseline characteristics and clinical outcomes at 3-month time point. Results: Twenty two pseudophakic eyes of 22 consecutive patients were included. Majority of patients had prior therapy with multiple intravitreal anti-VEGF injections. Four eyes had controlled glaucoma. At baseline mean VA and CRT were 50.7 letters and 631 μm respectively. After 3 months, 18 patients had improved CRT of which 15 of them also had improved VA. No adverse effects were noted. One additional patient required IOP lowering medication. Despite being unresponsive to multiple prior therapies including laser and anti-VEGF injections, switching to fluocinolone achieved treatment benefit. Conclusion: The patient level selection criteria proposed by NICE guidance on fluocinolone appeared to be implemented. This data from this study provides new evidence on early outcomes following fluocinolone therapy in eyes with DMO which had not responded to laser and other intravitreal agents.

Original languageEnglish
Article number3
JournalBMC Ophthalmology
Volume16
Issue number1
DOIs
Publication statusPublished - 5 Jan 2016

Fingerprint

Macular Edema
Patient Selection
Therapeutics
Vascular Endothelial Growth Factor A
Fluocinolone Acetonide
Injections
Laser Therapy
Glaucoma
Lasers
Retrospective Studies
fluocinolone

Bibliographical note

© 2015 Elaraoud et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Keywords

  • diabetic macular oedema
  • fluocinolone acetonide
  • iluvien
  • patient selection
  • early clinical outcome
  • visual acuity
  • central retinal thickness

Cite this

Elaraoud, Ibrahim ; Andreatta, Walter ; Kidess, Andrej ; Bhatnagar, Ajay ; Tsaloumas, Marie ; Quhill, Fahad ; Yang, Yit. / Use of flucinolone acetonide for patients with diabetic macular oedema : patient selection criteria and early outcomes in real world setting. In: BMC Ophthalmology. 2016 ; Vol. 16, No. 1.
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Use of flucinolone acetonide for patients with diabetic macular oedema : patient selection criteria and early outcomes in real world setting. / Elaraoud, Ibrahim; Andreatta, Walter; Kidess, Andrej; Bhatnagar, Ajay; Tsaloumas, Marie; Quhill, Fahad; Yang, Yit.

In: BMC Ophthalmology, Vol. 16, No. 1, 3, 05.01.2016.

Research output: Contribution to journalArticle

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T1 - Use of flucinolone acetonide for patients with diabetic macular oedema

T2 - patient selection criteria and early outcomes in real world setting

AU - Elaraoud, Ibrahim

AU - Andreatta, Walter

AU - Kidess, Andrej

AU - Bhatnagar, Ajay

AU - Tsaloumas, Marie

AU - Quhill, Fahad

AU - Yang, Yit

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PY - 2016/1/5

Y1 - 2016/1/5

N2 - Introduction: Fluocinolone acetonide slow release implant (Iluvien®) was approved in December 2013 in UK for treatment of eyes which are pseudophakic with DMO that is unresponsive to other available therapies. This approval was based on evidence from FAME trials which were conducted at a time when ranibizumab was not available. There is a paucity of data on implementation of guidance on selecting patients for this treatment modality and also on the real world outcome of fluocinolone therapy especially in those patients that have been unresponsive to ranibizumab therapy. Method: Retrospective study of consecutive patients treated with fluocinolone between January and August 2014 at three sites were included to evaluate selection criteria used, baseline characteristics and clinical outcomes at 3-month time point. Results: Twenty two pseudophakic eyes of 22 consecutive patients were included. Majority of patients had prior therapy with multiple intravitreal anti-VEGF injections. Four eyes had controlled glaucoma. At baseline mean VA and CRT were 50.7 letters and 631 μm respectively. After 3 months, 18 patients had improved CRT of which 15 of them also had improved VA. No adverse effects were noted. One additional patient required IOP lowering medication. Despite being unresponsive to multiple prior therapies including laser and anti-VEGF injections, switching to fluocinolone achieved treatment benefit. Conclusion: The patient level selection criteria proposed by NICE guidance on fluocinolone appeared to be implemented. This data from this study provides new evidence on early outcomes following fluocinolone therapy in eyes with DMO which had not responded to laser and other intravitreal agents.

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