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Rapid Structural and Functional Improvements with the 0.19 mg Fluocinolone Acetonide Intravitreal Implant for Patients with DME and Low Visual Acuity: 6-Month Data from the UAE

Authors Elbarky AM

Received 15 November 2019

Accepted for publication 28 January 2020

Published 16 March 2020 Volume 2020:14 Pages 823—830

DOI https://doi.org/10.2147/OPTH.S238740

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Ahmed Mohammed Elbarky1,2

1Vitreoretinal consultant, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; 2Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Egypt

Correspondence: Ahmed Mohammed Elbarky Email abarky@yahoo.com

Purpose: The 0.19 mg fluocinolone acetonide (FAc) intravitreal implant is approved in the United Arab Emirates (UAE) for treating diabetic macular edema (DME) in patients previously treated with a course of corticosteroids and that did not have a clinically significant rise in intraocular pressure (IOP). This ongoing study is assessing its effectiveness and safety in pseudophakic patients with DME in clinical practice from a single center in the UAE.
Methods: A retrospective, ongoing 6-month audit study (NCT03590587), in which 22 eyes from 22 patients were treated with a single FAc intravitreal implant after treatment with a prior course of corticosteroids. Outcomes assessed included mean changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and IOP. Six-month follow-up data are presented.
Results: After FAc implantation, mean BCVA improved rapidly, increasing by 25.4 ± 3.0 letters (mean±SEM) from baseline to Month 6 (p< 0.0001). At 6 months, BCVA had improved by 15 letters or more in 91% of eyes (n=20/22). Mean CMT decreased by 267.0 ± 20.1 μm from baseline to Month 6 (p< 0.0001). Over 85% of eyes (n=19/22) had a CMT less than 300 μm at 6 months. Mean IOP increased by 2.9 ± 0.7 mmHg from baseline to Month 6 (p< 0.001). All eyes except 2 had an IOP of 21 mmHg or lower. At Month 6, five eyes (23%) needed IOP-lowering therapy.
Conclusion: Injection of the FAc intravitreal implant rapidly and significantly improved BCVA and CMT within 6 months. These rapid and significant improvements exceed those reported in other real-world studies. Safety signals were consistent with corticosteroid class effects. The FAc implant may be a useful treatment option for patients in the UAE, particularly those with sight threatening DME requiring rapid functional improvements.

Keywords: diabetic macular edema, fluocinolone acetonide intravitreal implant, clinical evidence


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