Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients

Anne Studsgaard; Kåre Ørts Clemmensen; Mette Slot Nielsen

doi:10.1007/s00417-021-05504-6

Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients

Anne Studsgaard^*, Kåre Ørts Clemmensen, Mette Slot Nielsen

^*Corresponding author for this work

Department of Clinical Medicine - Department of Ophthalmology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

13 Citations (Scopus)

Abstract

Purpose: To evaluate intravitreal 0.19 mg fluocinolone acetonide implant (FAi) (Iluvien®) for the treatment of chronic non-infectious uveitis with associated cystoid macular edema (CME). Methods: A retrospective review of medical reports from a single Danish tertiary centre including 20 patients (20 eyes), treated with 0.19 mg FAi for non-infectious uveitic CME. The primary endpoints were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). The secondary endpoints were recurrence rate, change in systemic treatment, and intraocular pressure (IOP). Results: Mean follow-up of the 20 eyes was 2.3 ± 1.1 years. BCVA improved at 6 (p = 0.13), 12 (p = 0.05), 18 (p = 0.03), and 24 months and CRT decreased at 6 (p = 0.004), 12 (p = 0.006), 18, and 24 months after 0.19 mg FAi. Within 18 months after implantation, four of 14 patients (28.6%) relapsed. Three of five patients discontinued systemic corticosteroids within 4 months and one patient continued with reduced dose. Five of 10 patients receiving disease-modifying antirheumatic drugs (DMARDs) at time of implantation discontinued within 1 year. No patients started new systemic treatment. Eight eyes were treated with topical IOP-lowering medication at the time of implantation, of these two later underwent trabeculectomy. There were no complications associated with previous glaucoma surgery. Conclusion: This long-term follow-up study showed that intravitreal treatment with 0.19 mg FAi should be considered in the treatment of chronic non-infectious uveitic CME in selected patients. This treatment is safe even in selected glaucoma patients and may offer reduction or cessation of local or systemic anti-inflammatory treatment.

Original language	English
Journal	Graefe's Archive for Clinical and Experimental Ophthalmology
Volume	260
Issue	5
Pages (from-to)	1633-1639
Number of pages	7
ISSN	0721-832X
DOIs	https://doi.org/10.1007/s00417-021-05504-6
Publication status	Published - May 2022

Keywords

Cystoid macular edema
Fluocinolone acetonide
Iluvien®
Intravitreal treatment
Non-infectious uveitis

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10.1007/s00417-021-05504-6

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title = "Intravitreal fluocinolone acetonide 0.19 mg (Iluvien{\textregistered}) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients",

abstract = "Purpose: To evaluate intravitreal 0.19 mg fluocinolone acetonide implant (FAi) (Iluvien{\textregistered}) for the treatment of chronic non-infectious uveitis with associated cystoid macular edema (CME). Methods: A retrospective review of medical reports from a single Danish tertiary centre including 20 patients (20 eyes), treated with 0.19 mg FAi for non-infectious uveitic CME. The primary endpoints were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). The secondary endpoints were recurrence rate, change in systemic treatment, and intraocular pressure (IOP). Results: Mean follow-up of the 20 eyes was 2.3 ± 1.1 years. BCVA improved at 6 (p = 0.13), 12 (p = 0.05), 18 (p = 0.03), and 24 months and CRT decreased at 6 (p = 0.004), 12 (p = 0.006), 18, and 24 months after 0.19 mg FAi. Within 18 months after implantation, four of 14 patients (28.6%) relapsed. Three of five patients discontinued systemic corticosteroids within 4 months and one patient continued with reduced dose. Five of 10 patients receiving disease-modifying antirheumatic drugs (DMARDs) at time of implantation discontinued within 1 year. No patients started new systemic treatment. Eight eyes were treated with topical IOP-lowering medication at the time of implantation, of these two later underwent trabeculectomy. There were no complications associated with previous glaucoma surgery. Conclusion: This long-term follow-up study showed that intravitreal treatment with 0.19 mg FAi should be considered in the treatment of chronic non-infectious uveitic CME in selected patients. This treatment is safe even in selected glaucoma patients and may offer reduction or cessation of local or systemic anti-inflammatory treatment.",

keywords = "Cystoid macular edema, Fluocinolone acetonide, Iluvien{\textregistered}, Intravitreal treatment, Non-infectious uveitis",

author = "Anne Studsgaard and Clemmensen, {K{\aa}re {\O}rts} and Nielsen, {Mette Slot}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",

year = "2022",

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doi = "10.1007/s00417-021-05504-6",

language = "English",

volume = "260",

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Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients. / Studsgaard, Anne; Clemmensen, Kåre Ørts; Nielsen, Mette Slot.
In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 260, No. 5, 05.2022, p. 1633-1639.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema

T2 - 2-year follow-up of 20 patients

AU - Studsgaard, Anne

AU - Clemmensen, Kåre Ørts

AU - Nielsen, Mette Slot

PY - 2022/5

Y1 - 2022/5

N2 - Purpose: To evaluate intravitreal 0.19 mg fluocinolone acetonide implant (FAi) (Iluvien®) for the treatment of chronic non-infectious uveitis with associated cystoid macular edema (CME). Methods: A retrospective review of medical reports from a single Danish tertiary centre including 20 patients (20 eyes), treated with 0.19 mg FAi for non-infectious uveitic CME. The primary endpoints were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). The secondary endpoints were recurrence rate, change in systemic treatment, and intraocular pressure (IOP). Results: Mean follow-up of the 20 eyes was 2.3 ± 1.1 years. BCVA improved at 6 (p = 0.13), 12 (p = 0.05), 18 (p = 0.03), and 24 months and CRT decreased at 6 (p = 0.004), 12 (p = 0.006), 18, and 24 months after 0.19 mg FAi. Within 18 months after implantation, four of 14 patients (28.6%) relapsed. Three of five patients discontinued systemic corticosteroids within 4 months and one patient continued with reduced dose. Five of 10 patients receiving disease-modifying antirheumatic drugs (DMARDs) at time of implantation discontinued within 1 year. No patients started new systemic treatment. Eight eyes were treated with topical IOP-lowering medication at the time of implantation, of these two later underwent trabeculectomy. There were no complications associated with previous glaucoma surgery. Conclusion: This long-term follow-up study showed that intravitreal treatment with 0.19 mg FAi should be considered in the treatment of chronic non-infectious uveitic CME in selected patients. This treatment is safe even in selected glaucoma patients and may offer reduction or cessation of local or systemic anti-inflammatory treatment.

AB - Purpose: To evaluate intravitreal 0.19 mg fluocinolone acetonide implant (FAi) (Iluvien®) for the treatment of chronic non-infectious uveitis with associated cystoid macular edema (CME). Methods: A retrospective review of medical reports from a single Danish tertiary centre including 20 patients (20 eyes), treated with 0.19 mg FAi for non-infectious uveitic CME. The primary endpoints were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). The secondary endpoints were recurrence rate, change in systemic treatment, and intraocular pressure (IOP). Results: Mean follow-up of the 20 eyes was 2.3 ± 1.1 years. BCVA improved at 6 (p = 0.13), 12 (p = 0.05), 18 (p = 0.03), and 24 months and CRT decreased at 6 (p = 0.004), 12 (p = 0.006), 18, and 24 months after 0.19 mg FAi. Within 18 months after implantation, four of 14 patients (28.6%) relapsed. Three of five patients discontinued systemic corticosteroids within 4 months and one patient continued with reduced dose. Five of 10 patients receiving disease-modifying antirheumatic drugs (DMARDs) at time of implantation discontinued within 1 year. No patients started new systemic treatment. Eight eyes were treated with topical IOP-lowering medication at the time of implantation, of these two later underwent trabeculectomy. There were no complications associated with previous glaucoma surgery. Conclusion: This long-term follow-up study showed that intravitreal treatment with 0.19 mg FAi should be considered in the treatment of chronic non-infectious uveitic CME in selected patients. This treatment is safe even in selected glaucoma patients and may offer reduction or cessation of local or systemic anti-inflammatory treatment.

KW - Cystoid macular edema

KW - Fluocinolone acetonide

KW - Iluvien®

KW - Intravitreal treatment

KW - Non-infectious uveitis

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DO - 10.1007/s00417-021-05504-6

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JO - Graefe's Archive for Clinical and Experimental Ophthalmology

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Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients

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