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Iluvien monotherapy for diabetic macular oedema in vitrectomised and non‐vitrectomised eyes: one year data
Author(s) -
Hawrami A.,
Laviers H.,
Patra S.,
Zambarakji H.
Publication year - 2016
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.1755-3768.2016.0562
Subject(s) - medicine , pars plana , ophthalmology , diabetic retinopathy , fluocinolone acetonide , implant , visual acuity , vitrectomy , macular edema , retinal , diabetic macular edema , surgery , diabetes mellitus , endocrinology
Purpose To assess the effectiveness of the Fluocinolone intravitreal implant (Iluvien) in patients with diabetic macular oedema (DMO) following previous pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). The data from vitrectomised eyes are compared with a consecutive group of non‐vitrectomised eyes with DMO who received the Iluvien implant in our institution. Methods Retrospective analysis of a consecutive series of patients who received the Iluvien implant for DMO. Best‐corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and 0–2 months, 3–5 months and 6–12 months following placement of the implant. Analysis of variance was carried out using Stata 14.1 (StatCorp LP) Software. Results Seven eyes with recent PPV and 17 eyes without previous PPV received an Iluvien implant for DMO. Mean improvement in BCVA in the PPV group to 6–12 months was 0.33 logMAR (95% CI: −0.2 to 0.8) compared with 0.13 logMAR (95% CI: 0.0–0.2) in the no PPV group (p = 0.355). Mean improvement in CMT in the PPV group to 6–12 months was 59.6 μ m (95% CI: 18.0–137.2) compared with 78.4 μ m (95% CI: 21.3–126.9) in the no PPV group (p = 0.745). Individual OCT images showed persistent cystoid macular oedema in 7/7 eyes in the PPV group. A persistent pre retinal hyper‐reflective line at the macula suggestive of residual cortical vitreous or pre retinal membrane was identified in 4/7 eyes in the PPV group and 9/17 eyes in the non‐PPV group. Conclusions Vitreoretinal interface proliferation may explain the absence of a response to intravitreal Iluvien in some DMO eyes. Prospective randomised studies are needed in order to establish a uniform evidence based approach for classification and treatment in vitrectomised eyes.