Introduction:

Diabetic macular oedema (DMO) is a well known complication of diabetes. Until the last decade argon laser was considered the gold standard treatment of clinically significant macular oedema. Recent landmark studies (READ2, RESTORE, Relight, DRCR.net protocol I) shifted the focus of treatment towards intravitreal injections of anti-VEGF. However, anti-VEGF showed a limited effect in chronic CMO. The FAME study revealed promising results in the use of Flucinolone Acetate implant (Illuvien) in treating chronic refractory DMO. We would like to share six months results of Illuvien in patients with DMO who have failed other treatments including its effect on visual gain (VG) and central macular thickness (CMT).

Methods:

Retrospective case series of 17 eyes with six months follow up data.

Results:

Eight patients (47%) had improvement in both VG and CRT. Two patients had VG of more than five EDTRS-letters. Six patients had VG of more than 10 EDTRS-letters with average CMT reduction of 74 micrometres. Five patients (29.5%) had no change in their vision, despite average reduction of 90 micrometres of their CMT. Four patients (23.5%) lost vision. Three of them showed improvement in CMT.

Discussion:

Illuvien is playing an important role in the management of chronic and refractory DMO. Despite being non respondent to anti-VEGF treatment, nearly half of the subjects in our series showed visual improvement following Illuvien injection. The percentage could further increase as the FAME study showed that some individuals are late responders.

Contact Details:

Email: drelaraoud@doctors.net.uk
Cell Phone: +447771222777