Fluocinolone Acetonide 0.19 mg Implant in Patients with Cystoid Macular Edema Due To Irvine–Gass Syndrome
Received 1 December 2020
Accepted for publication 13 January 2021
Published 26 February 2021 Volume 2021:14 Pages 127—132
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
João Heitor Marques,1 Ana Carolina Abreu,1 Nisa Silva,1 Angelina Meireles,1,2 Bernardete Pessoa,1,2 João Melo Beirão1,2
1Serviço de Oftalmologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
Correspondence: João Heitor Marques
Centro Hospitalar Universitário do Porto, Serviço de Oftalmologia, Largo do Prof. Abel Salazar, Porto, 4099-001, Portugal
Email [email protected]
Background: Cystoid macular edema (CME) due to Irvine–Gass syndrome (IGS) is one of the common causes of painless visual impairment post-cataract extraction. The treatment of recurrent cases remains unstandardized.
Objective: To evaluate the effectiveness and safety of fluocinolone acetonide intravitreal implant (0.2 μg/day; ILUVIEN®) in the off-label treatment of recurrent CME due to IGS.
Methods: Retrospective 36-month case series in the Ophthalmology Department of Centro Hospitalar Universitário do Porto, Portugal. Consecutive eyes of patients with recurrent cystoid macular edema due to Irvine–Gass syndrome who underwent a single intravitreal injection of fluocinolone acetonide intravitreal implant were included. Best-corrected visual acuity (logMAR), central macular thickness (μm) and safety (intraocular pressure, mmHg) at baseline and at 6, 12, 24 and 36 months post-administration of the fluocinolone acetonide intravitreal implant were recorded.
Results: Five eyes from three patients were included. The duration of cystoid macular edema was 67.8± 25.9 months and all five eyes received more than 2 intravitreal injections of a corticosteroid (triamcinolone and/or dexamethasone implant) prior to fluocinolone acetonide intravitreal implantation. At baseline (median – interquartile range), best-corrected visual acuity was 0.3– 0.3; central macular thickness was 492.0– 38.0; and intraocular pressure was 16.0– 0. By Month 36, best-corrected visual acuity was 0.4 − 0.3; central macular thickness was reduced to 369.0– 324.0 and intraocular pressure was 17.0– 3.0. Four of five eyes had increased intraocular pressure and were managed with intraocular pressure-lowering eye drops.
Conclusion: We report improved functional and anatomical outcomes after treatment with fluocinolone acetonide intravitreal implant, indicating its use as a therapeutic alternative in recurrent cases of cystoid macular edema due to Irvine–Gass syndrome. Additionally, in eyes with suboptimal response to intravitreal therapies, fluocinolone acetonide intravitreal implant may provide longer recurrence-free periods with reduced treatment burden.
Keywords: cataract surgery, Irvine–Gass syndrome, cystoid macular edema, pseudophakic cystoid macular edema, fluocinolone acetonide
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