Fluocinolone Acetonide Implant Injected 1 Month after Dexamethasone Implant for Diabetic Macular Oedema: the ILUVI1MOIS Study

• Published in: Ophthalmology and therapy Vol. 12; no. 5; pp. 2781 - 2792
• Main Authors: Rousseau, Nicolas, Lebreton, Olivier, Masse, Hélène, Maucourant, Yann, Pipelart, Valentin, Clement, Manon, Le Lez, Marie-Laure, Khanna, Raoul Kanav, Pepin, Maxime, Eude, Yannick, Le Meur, Guylène, Weber, Michel, Ducloyer, Jean-Baptiste
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.10.2023; Adis, Springer Healthcare
• Subjects: Brief Report; Corticosteroid implant; Dexamethasone; Diabetes complications; Diabetic macular oedema; DME; Fluocinolone acetonide; Internal Medicine; Medicine; Medicine & Public Health; Ophthalmology; Dexamethasone; Diabetes complications; Fluocinolone acetonide; Intravitreal injection; Diabetic macular oedema; Corticosteroid implant; DME; Retinal diseases
• ISSN: 2193-8245; 2193-6528
• DOI: 10.1007/s40123-023-00749-2

Introduction The aim of this study was to assess the efficacy and safety of fluocinolone acetonide implant (FAci) injected 1 month after the last dexamethasone intravitreal implant (DEXi) in chronic diabetic macular oedema (DME) patients. Methods Retrospective multicentric study conducted in pseudophakic patients with chronic DME frequently treated with dexamethasone intravitreal implant (DEXi; time to DME recurrence ≤ 6 months), receiving FAci 1 month after the last DEXi, with at least a 6-month follow-up. Best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography, intraocular pressure (IOP) and additional treatments were assessed on the day of FAci injection (M0), 1 (M1) and 3 months (M3) later and then every 3 months. Results A total of 41 eyes from 34 patients were included. At M0, patients’ mean age was 68.7 ± 9.8 years, the mean DME duration was 63.9 ± 22.9 months, the mean interval between two DEXi was 14.2 ± 3.3 weeks. M12 data were available for 71% of patients. At baseline, the mean BCVA, CMT and IOP were 63.2 ± 16.6 letters, 299.4 ± 103.3 µm, and 16.2 ± 4.5 mmHg, respectively, and remained stable during the follow-up. At M12, 14% of patients required additional intravitreal treatments. Conclusion In pseudophakic patients with chronic DME showing good response to DEXi but requiring repeated injections every < 6 months, switching to FAci 1 month after the last DEXi was effective and safe. Further prospective randomized controlled studies are needed to confirm these findings, and to determine the best interval between the last DEXi and the first FAci.