Hohberger Bettina, Royer Melanie, Flamann Cindy Sheree, Bergua Antonio
Department of Ophthalmology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany.
Alimera Sciences Ophthalmologie GmbH, 10709 Berlin, Germany.
J Clin Med. 2025 Apr 21;14(8):2849. doi: 10.3390/jcm14082849.
: Chronic macular edema (CME) is a common complication of diabetic retinopathy or non-infectious uveitis affecting the posterior segment (NIU-PS). Alongside anti-VEGF therapy, glucocorticoids are frequently used to manage CME. Given the heterogeneous nature of patients' medical history, their social conditions, and disease manifestations, individualized treatment is essential for optimal outcomes. This study assesses the effectiveness of intravitreal fluocinolone acetonide (FA) (Iluvien) in treating persistent and recurrent macular edema in clinical practice at the University Hospital of Erlangen-Nuremberg, Germany. : A total of 46 eyes with diabetic macular edema (DME) (21 eyes) and NIU-PS (25 eyes) were retrospectively analyzed over a follow-up period of up to 36 months. Since persistent retinal thickness fluctuations are linked to long-term retinal damage and functional decline, this study analyzed central retinal thickness (CRT)-including its fluctuations measured as CRT amplitude-alongside BCVA as the primary outcomes. : After an initial decrease in CRT in the first year after FA treatment, the maximum CRT amplitude significantly decreased in the following years. For patients with DME, CRT amplitude reduced from 271.4 µm to 91.57 µm in the first year ( = 0.0056) and 106.0 µm in the second year ( = 0.0109). For patients with NIU-PS, CRT amplitude decreased from 185.2 µm to 87.7 µm in the first year ( = 0.0131) and 97.3 µm in the second year ( = 0.0375). Mean BCVA remained stable in both cohorts. : Intravitreal FA proved to be effective in reducing and stabilizing CRT in patients with chronic DME and NIU-PS without losing visual acuity, reducing treatment burden.
慢性黄斑水肿（CME）是糖尿病性视网膜病变或影响眼后段的非感染性葡萄膜炎（NIU-PS）的常见并发症。除抗血管内皮生长因子（VEGF）治疗外，糖皮质激素也常用于治疗CME。鉴于患者病史、社会状况和疾病表现的异质性，个体化治疗对于获得最佳疗效至关重要。本研究评估了玻璃体内注射曲安奈德（FA）（Iluvien）在德国埃尔朗根 - 纽伦堡大学医院临床实践中治疗持续性和复发性黄斑水肿的有效性。
共对46只患有糖尿病性黄斑水肿（DME）（21只眼）和NIU-PS（25只眼）的眼睛进行了回顾性分析，随访期长达36个月。由于持续性视网膜厚度波动与长期视网膜损伤和功能下降有关，本研究分析了中央视网膜厚度（CRT），包括将其波动作为CRT幅度进行测量，并将最佳矫正视力（BCVA）作为主要观察指标。
在FA治疗后的第一年CRT初步下降后，随后几年中最大CRT幅度显著降低。对于DME患者，CRT幅度在第一年从271.4 µm降至91.57 µm（P = 0.0056），在第二年降至106.0 µm（P = 0.0109）。对于NIU-PS患者，CRT幅度在第一年从185.2 µm降至87.7 µm（P = 0.0131），在第二年降至97.3 µm（P = 0.0375）。两个队列中的平均BCVA均保持稳定。
玻璃体内注射FA被证明在降低和稳定慢性DME和NIU-PS患者的CRT方面有效，且不丧失视力，减轻了治疗负担。
