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Importance: Early experience with intraocular, non-biodegradable fluocinolone acetonide (FAc) (0.2 μg/day) implant (ILUVIEN®), comparing visual function before and after treatment in an insufficiently responsive diabetic macular oedema (DMO) patient. Observations: This 62-yearold male patient with type 2 diabetes mellitus was first treated for DMO in 2004, when best corrected visual acuity (BCVA) was 0.8 for his right eye. He did not visit an ophthalmologist again until 2011 when BCVA had declined to 0.2. Three separate, monthly intravitreal (IV) ranibizumab injections and additional laser photocoagulation resulted in no improvement. Subsequently, 0.7 mg IV dexamethasone was administered, giving short-term DMO improvement. However, six further IV ranibizumab injections produced no effect and a combined injection of IV ranibizumab with 0.7 mg IV dexamethasone provided only short-term improvements. Following phacoemulsification, a 0.2 μg/day FAc implant was administered. Optical coherence tomography (OCT) indicated complete DMO regression after 3 weeks, sustained 6 months post-implant. BCVA improved to 0.25 and the patient reported greater vision-related quality of life. Intraocular pressure increased gradually but resolved with daily timolol/dorzolamide and tafluoprost eye drops. Conclusions and relevance: In a DMO patient showing insufficient response to IV ranibizumab and dexamethasone injections, FAc implant provided an effective therapeutic option with manageable side effects.

european ophthalmic review

Visual Function and Structure Outcomes in a Patient with Diabetic Macular Oedema Insufficiently Responsive to Available Therapies – Treatment with Fluocinolone Acetonide Implant