gms | German Medical Science

Introduction: We report 12 and 24 month visual and anatomical outcomes of chronic/refractory diabetic macular edema (DME) treated for the first time with intravitreal fluocinolone acetonide implant (ILUVIEN) in a tertiary referral center.

Method: Retrospective data collection and analysis of 15 consecutive eyes of 13 diabetic patients (8 men, 5 women) who received an ILUVIEN implant for refractory/recurrent DME of 50 +-12 months duration. Assessment included visual acuity (VA), central retinal thickness (CRT), biomicroscopy, and Goldmann tonometry intraocular pressure (IOP) at 12 and 24 months.

Results: Between 2013 and 2017, we treated 15 eyes of 13 patients (8 men and 5 women) with chronic/refractory DME treated prior to ILUVIEN for 50±12 months. Baseline mean VA logMAR 0.6±0.2 improved to 0.4±0.2 (P=0.01) at 12 months and 0.38±0.1 at 24 months (P=0.04). VA improved in 11 eyes (73%), stabilized in 2 eyes (13%), and decreased in 2 eyes (13%). Mean CRT decreased from 489±133 μm to 342±107 μm at 12 months (P=0.0005) and 284±41 μm at 24 months (P=0.001). At 12 months only one eye required additional treatment for DME. Over 24 months, only 2 eyes required local medication for raised IOP.

Discussion: Our real-world results show that the visual and anatomical improvements achieved by a single ILUVIEN intravitreal implant were maintained up to 24 months with minimal additional therapy. IOP monitoring remains essential in ILUVIEN patients and in our study IOP was effectively managed with IOP-lowering drops when required.