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Steroids
Author(s) -
KODJIKIAN L
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.2614.x
Subject(s) - fluocinolone acetonide , medicine , diabetic macular edema , implant , dexamethasone , authorization , macular edema , triamcinolone acetonide , adverse effect , ophthalmology , diabetic retinopathy , visual acuity , surgery , pharmacology , diabetes mellitus , endocrinology , computer security , computer science
Diabetic macular edema (DME) is the most common cause of moderate vision loss in working‐age individuals in developed countries. Corticosteroids reduce expression of VEGF and other permeability, providing good rationale for their use in DME. The first steroid used was the triamcinolone by intravitreal injection. Efficacy was good but the adverse events were rather important (elevated intraocular pressure being the most common). Different steroids implant with sustained ocular delivery are available. The Fluocinolone Acetonide for Macular Edema (FAME) studies permitted to the ILUVIEN® implant (190 µg) has received its marketing authorization approval in different European countries. It is indicated for the treatment of vision impairment associated with chronic DME, considered insufficiently responsive to available therapies. Dexamethasone Intravitreal Implant (OZURDEX®) provided long‐term vision improvement, with a mean of 4.1 injections over 3 years (phase III MEAD study). Its label is not yet obtained (March 2014). It safety profile was better or equivalent than that of steroids currently used in clinical practice. In summary, two platforms for sustained steroids drug delivery are available in DME.