Cargando…

The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema

PURPOSE: There are little or no published data comparing the outcomes of ILUVIEN(®) (0.19 mg fluocinolone acetonide [FAc]) and OZURDEX(®) (0.7 mg dexamethasone [DEX]) implants in patients with diabetic macular edema (DME), and this case sought to compare their outcomes. METHODS: This case was extrac...

Descripción completa

Detalles Bibliográficos
Autores principales: Singh, P, Chedid, A, Deuchler, SK, Kohnen, T, Müller, M, Koch, FH
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198890/
https://www.ncbi.nlm.nih.gov/pubmed/30410411
http://dx.doi.org/10.2147/IMCRJ.S174461
_version_ 1783365037264470016
author Singh, P
Chedid, A
Deuchler, SK
Kohnen, T
Müller, M
Koch, FH
author_facet Singh, P
Chedid, A
Deuchler, SK
Kohnen, T
Müller, M
Koch, FH
author_sort Singh, P
collection PubMed
description PURPOSE: There are little or no published data comparing the outcomes of ILUVIEN(®) (0.19 mg fluocinolone acetonide [FAc]) and OZURDEX(®) (0.7 mg dexamethasone [DEX]) implants in patients with diabetic macular edema (DME), and this case sought to compare their outcomes. METHODS: This case was extracted from a monocentric audit involving a pool of 25 patients (33 eyes) with DME and treated with a single FAc implant between October 2013 and December 2016. This case, a 61-year-old male with a pseudophakic lens, is from a patient that had received 4 intravitreal injections of a DEX implant prior to FAc implant and then was monitored for 3 years until re-treatment with a second FAc implant. Parameters measured included visual acuity (VA), central retinal thickness (CRT), and intraocular pressure (IOP). RESULTS: After the DEX implants, CRT transiently improved. In March 2014, the decision was taken to administer an FAc implant, and this led to a reduction in CRT below 300 µm (from a baseline of 748 µm), and this was sustained for 30 months. VA remained above 65 Early Treatment Diabetic Retinopathy Study letters to month 36, after which time a second FAc implant (in April 2017) was administered due to recurrence of edema and CRT decreased to below 300 µm and VA improved to 70 letters. Side effects included elevated IOP, which was effectively managed with IOP-lowering drops. CONCLUSION: A single injection of FAc implant led to sustained improvements in CRT and VA that lasted for between 30 and 36 months, which is in contrast to the DEX implant where re-treatment was generally required within 6–7 months. After 36 months, re-treatment with the FAc implant again led to improved VA and CRT, and responses that were similar to those achieved with the first FAc implant.
format Online
Article
Text
id pubmed-6198890
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-61988902018-11-08 The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema Singh, P Chedid, A Deuchler, SK Kohnen, T Müller, M Koch, FH Int Med Case Rep J Case Report PURPOSE: There are little or no published data comparing the outcomes of ILUVIEN(®) (0.19 mg fluocinolone acetonide [FAc]) and OZURDEX(®) (0.7 mg dexamethasone [DEX]) implants in patients with diabetic macular edema (DME), and this case sought to compare their outcomes. METHODS: This case was extracted from a monocentric audit involving a pool of 25 patients (33 eyes) with DME and treated with a single FAc implant between October 2013 and December 2016. This case, a 61-year-old male with a pseudophakic lens, is from a patient that had received 4 intravitreal injections of a DEX implant prior to FAc implant and then was monitored for 3 years until re-treatment with a second FAc implant. Parameters measured included visual acuity (VA), central retinal thickness (CRT), and intraocular pressure (IOP). RESULTS: After the DEX implants, CRT transiently improved. In March 2014, the decision was taken to administer an FAc implant, and this led to a reduction in CRT below 300 µm (from a baseline of 748 µm), and this was sustained for 30 months. VA remained above 65 Early Treatment Diabetic Retinopathy Study letters to month 36, after which time a second FAc implant (in April 2017) was administered due to recurrence of edema and CRT decreased to below 300 µm and VA improved to 70 letters. Side effects included elevated IOP, which was effectively managed with IOP-lowering drops. CONCLUSION: A single injection of FAc implant led to sustained improvements in CRT and VA that lasted for between 30 and 36 months, which is in contrast to the DEX implant where re-treatment was generally required within 6–7 months. After 36 months, re-treatment with the FAc implant again led to improved VA and CRT, and responses that were similar to those achieved with the first FAc implant. Dove Medical Press 2018-10-15 /pmc/articles/PMC6198890/ /pubmed/30410411 http://dx.doi.org/10.2147/IMCRJ.S174461 Text en © 2018 Singh et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Singh, P
Chedid, A
Deuchler, SK
Kohnen, T
Müller, M
Koch, FH
The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title_full The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title_fullStr The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title_full_unstemmed The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title_short The efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
title_sort efficacy and safety outcomes of the 0.19 mg fluocinolone acetonide implant after prior treatment with the 0.7 mg dexamethasone implant in patients with diabetic macular edema
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198890/
https://www.ncbi.nlm.nih.gov/pubmed/30410411
http://dx.doi.org/10.2147/IMCRJ.S174461
work_keys_str_mv AT singhp theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT chedida theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT deuchlersk theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT kohnent theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT mullerm theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT kochfh theefficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT singhp efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT chedida efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT deuchlersk efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT kohnent efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT mullerm efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema
AT kochfh efficacyandsafetyoutcomesofthe019mgfluocinoloneacetonideimplantafterpriortreatmentwiththe07mgdexamethasoneimplantinpatientswithdiabeticmacularedema