Fluocinolone acetonide intravitreal implant for the treatment of macular edema: Long‐term outcomes from a single tertiary hospital

Abstract

Purpose: Injectable long‐acting implant of Fluocinolone Acetonide (FAc) has proven useful for the treatment of macular edema of different etiologies. The aim of our study was to assess the real‐life safety and efficacy of FAc 0.19 mg intravitreal implant for the treatment of macular edema. Methods: We retrospectively collected data from all patients with macular edema prescribed with FAc intravitreal implant between January 2019 and May 2022 in a single tertiary hospital. Central retinal thickness (CRT), visual acuity (VA), intraocular pressure (IOP) and need for cataract surgery were measured as the endpoints of interest at baseline and were reevaluated every 3 months. Results: Finally, 41 patients, contributing 51 eyes, were included in the analysis. Most frequent indication for prescription was macular diabetic edema (n = 33, 64.7%), followed by uveitis (n = 9, 17.6%) and others (iris‐supported phakic intraocular lens, retinal vein occlusion, Irvinne Gass syndrome and post‐retinal detachment surgery; n = 9, 17.6%). In terms of efficacy, at a median follow‐up of 20.3 months, a reduction in CRT was observed (from 438 μm to 299 μmat at 12 months) and this resulted in an improvement in VA (from 0,30 to 0,41 at 12 months), mostly in uveitis group. In terms of safety and secondary effects, no endophthalmitis was reported and IOP increased at follow‐up with 20 eyes requiring topical IOP‐lowering drops. All phakic eyes at baseline (n = 10, 19.6%) were referred to cataract surgery in the follow‐up, at a mean of 13 months after FAc injection. Conclusions: FAc intravitreal implant for the treatment of macular edema in real‐life patients resulted in improvement of both CRT and VA with predictable secondary effects and no major safety concerns.

Effectiveness and safety of fluocinolone acetonide intravitreal implant in diabetic macular edema patients considered insufficiently responsive to available therapies (REACT): a prospective, non-randomized, and multicenter study

“…Similarly, the anatomical results found in the REACT study are in line with the literature published to date [ 6 , 9 – 15 , 25 – 36 ].…”

“…These findings did not significantly differ from those published in the literature [ 6 , 9 – 15 , 25 – 36 ].…”

“…The effectiveness, in terms of visual and anatomic outcomes, of the FAc-i in patients with DME has been previously reported in different studies [ 6 , 9 – 15 , 25 – 34 ]. According to the results of a systematic-review and meta-analysis, the FAc-i provided a mean peak visual improvement of + 8.7 letters (range: 0.4 to 18.8 letters, median + 8.0 letters) and a maximum CRT reduction of − 34.3% (range: − 10.7% to − 55.8%, median: − 36.2%) from baseline [ 35 ].…”

“…The evidence evaluating the effectiveness and safety of the FAc-i in the Spanish clinical setting is scarce and reflects the experience of retrospective and single center studies [ 15 , 16 ].…”