Wolverhampton Eye Infirmary, New Cross Hospital, Wednesfield Road, Wolverhampton, UK.
Royal Hallamshire Hospital, Glossop Road, Sheffield, UK.
Ophthalmol Ther. 2016 Jun;5(1):95-104. doi: 10.1007/s40123-016-0045-7. Epub 2016 Feb 17.
Patients with diabetic macular edema (DME), a chronic, vision-limiting condition, may be insufficiently responsive to standard-of-care anti-vascular endothelial growth factor (VEGF) and/or laser therapies. One approved treatment for such patients is 0.2 μg/day fluocinolone acetonide (FAc) sustained-release implant; however, data are limited for treatment strategies in patients with bilateral chronic DME insufficiently responsive to standard-of-care therapies.
Six pseudophakic patients with bilateral, chronic DME previously treated with laser and anti-VEGF therapy (and intravitreal triamcinolone acetonide in 10 eyes) were retrospectively investigated for visual and anatomical outcomes, 6 months post-0.2 μg/day FAc implant in both eyes.
At baseline, the mean best corrected visual acuity (BCVA) was approximately 6/38 or 43 [standard deviation (SD) ±17.4] Early Treatment Diabetic Retinopathy Study (ETDRS) letters; mean central retinal thickness (CRT) was 648 μm (SD ±160). Mean change in BCVA was +10 letters (SD ±12.2 letters), with 4/12 eyes maintaining or achieving driving vision (≥70 letters) and 3/12 eyes having unchanged BCVA. CRT was reduced 6 months after 0.2 μg/day FAc implant in 11/12 eyes. The mean intraocular pressure (IOP) was 16.1 mmHg [mean change of 1.1 mmHg (SD ±3.6)].
In a real-world setting, 0.2 μg/day FAc implant in both eyes was a feasible, effective choice for patients with severe bilateral DME, without notable increases in IOP.
Publication charges were funded by Alimera Sciences Ltd. Medical writing assistance for this study was provided by QXV Communications and funded by Alimera Sciences Ltd.
患有糖尿病性黄斑水肿(DME)的患者病情慢性且会限制视力,他们可能对标准护理的抗血管内皮生长因子(VEGF)和/或激光治疗反应不足。对于此类患者,一种已获批的治疗方法是 0.2μg/天氟轻松醋酸酯(FAc)持续释放植入物;然而,对于双侧慢性 DME 患者,在对标准护理治疗反应不足的情况下,治疗策略的数据有限。
回顾性研究了 6 名患有双侧慢性 DME 的已行白内障手术的患者,这些患者先前接受过激光和抗 VEGF 治疗(其中 10 只眼接受过玻璃体内曲安奈德治疗),并在双眼接受 0.2μg/天 FAc 植入后 6 个月进行了视力和解剖结构结果调查。
基线时,平均最佳矫正视力(BCVA)约为 6/38 或 43 [标准差(SD)±17.4] 早期糖尿病视网膜病变治疗研究(ETDRS)字母;平均中心视网膜厚度(CRT)为 648μm(SD±160)。BCVA 的平均变化为+10 个字母(SD±12.2 个字母),有 4/12 只眼保持或获得了驾驶视力(≥70 个字母),3/12 只眼的 BCVA 保持不变。在接受 0.2μg/天 FAc 植入后 6 个月,12 只眼中的 11 只眼 CRT 降低。平均眼内压(IOP)为 16.1mmHg[平均变化 1.1mmHg(SD±3.6)]。
在真实环境中,对于严重双侧 DME 患者,双眼接受 0.2μg/天 FAc 植入是一种可行且有效的选择,且眼压无明显升高。
出版费用由 Alimera Sciences Ltd 资助。本研究的医学写作协助由 QXV Communications 提供,并由 Alimera Sciences Ltd 资助。