El-Ghrably Ibraheem, Steel David H W, Habib Maged, Vaideanu-Collins Daniela, Manvikar Sridhar, Hillier Roxane J
Ophthalmology Department, James Cook University Hospital, Middlesbrough - UK.
Ophthalmology Department, Sunderland Eye Infirmary, Sunderland - UK.
Eur J Ophthalmol. 2017 May 11;27(3):357-362. doi: 10.5301/ejo.5000929. Epub 2017 Feb 6.
To conduct an observational, multicenter study to evaluate real-world clinical efficacy and safety of the 0.2 µg/day fluocinolone acetonide (FAc) implant in the treatment of patients with chronic diabetic macular edema (DME) in 3 large hospital ophthalmology departments in the United Kingdom.
Fluocinolone acetonide implants were inserted into the study eyes following a suitable washout period; phakic eyes received FAc implant following cataract surgery. Follow-up visits took place 2-4 weeks postinjection and then at 3, 6, and 12 months; change in central macular thickness (CMT) from baseline was measured by optical coherence tomography and best-corrected visual acuity (BCVA) was also assessed. Adverse events and changes in intraocular pressure (IOP) were recorded in order to evaluate the safety profile for the FAc implant.
Improvements in BCVA and CMT were observed from 3 months and sustained for the duration of observation. At 12 months, the overall mean change from baseline CMT was -126 μm and mean increase in BCVA from baseline was 5.1 letters. Increases in IOP following FAc implant were easily managed with IOP-lowering medication. Implant migration into the anterior chamber occurred in 2 eyes where prior vitrectomy had resulted in a posterior capsule defect; this was rectified and resolved.
The results of this study provide further efficacy and safety profile data for FAc implant treatment of chronic DME in a real-world clinical setting; the FAc implant appears to be a valuable therapeutic approach for patients with chronic DME who have suboptimal response to other treatment options.
开展一项观察性多中心研究,以评估0.2μg/天的醋酸氟轻松(FAc)植入物在英国3家大型医院眼科治疗慢性糖尿病性黄斑水肿(DME)患者中的真实世界临床疗效和安全性。
在适当的洗脱期后,将醋酸氟轻松植入物插入研究眼;有晶状体眼在白内障手术后接受FAc植入物。注射后2 - 4周进行随访,然后在3、6和12个月进行随访;通过光学相干断层扫描测量中心黄斑厚度(CMT)相对于基线的变化,并评估最佳矫正视力(BCVA)。记录不良事件和眼压(IOP)变化,以评估FAc植入物的安全性。
从3个月起观察到BCVA和CMT有所改善,并在观察期内持续。在12个月时,CMT相对于基线的总体平均变化为 -126μm,BCVA相对于基线的平均增加为5.1个字母。FAc植入后眼压升高可通过降低眼压的药物轻松控制。2只眼发生植入物向前房迁移,这2只眼之前的玻璃体切除术导致了后囊缺损;已进行纠正并解决。
本研究结果为FAc植入物在真实世界临床环境中治疗慢性DME提供了进一步的疗效和安全性数据;对于对其他治疗方案反应欠佳的慢性DME患者,FAc植入物似乎是一种有价值的治疗方法。