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  3. Clinical-Decision Criteria to Identify Recurrent Diabetic Macular Edema Patients Suitable for Fluocinolone Acetonide Implant Therapy (ILUVIEN ® ) and Follow-Up Considerations/Recommendations.

Clinical-Decision Criteria to Identify Recurrent Diabetic Macular Edema Patients Suitable for Fluocinolone Acetonide Implant Therapy (ILUVIEN ® ) and Follow-Up Considerations/Recommendations.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Adán A
  • Cabrera F
  • Figueroa MS
  • Cervera E
  • Ascaso FJ
  • Abraldes M
  • Reyes MÁ
  • Pazos M
  • Pessoa B
  • Armadá F

Grupos

Abstract

Current management of diabetic macular edema (DME) predominantly involves treatment with short-acting intravitreal injections of anti-vascular endothelial growth factors (anti-VEGFs) and/or corticosteroids; however, short-acting therapies (lasting between 1 and 6 months) require frequent injections to maintain efficacy, meaning a considerable treatment burden for diabetic patients with multiple comorbidities. Continuous injections needed in some cases are an economic burden for patients/healthcare system, so real-life clinical practice tends to adopt a reactive approach, ie, watch and wait for worsening symptoms, which consequently increases the risk of undertreatment and edema recurrence. On March 7th 2019, a group of experts in retinal medicine and surgery held a roundtable meeting in Madrid, Spain to discuss how to (1) optimize clinical outcomes through earlier use of fluocinolone acetonide (FAc) implant (ILUVIEN ® ) in patients with persistent or recurrent DME despite therapy; and, (2) to provide guidance to assist physicians in deciding which patients should be treated with ILUVIEN. In this regard, a 36-month follow-up consensus protocol is presented. In conclusion, patients that achieve a complete or partial anatomical, and preferably functional, response following one or two intravitreal dexamethasone implants, but with recurrence of edema after 3-4 months, are deemed by the authors most likely to benefit from ILUVIEN, and the switch to FAc implant should not be delayed more than 12 months after the initiation of at least the first dexamethasone implant.

Datos de la publicación

ISSN/ISSNe:
1177-5483, 1177-5483

Clinical Ophthalmology  DOVE MEDICAL PRESS LTD

Tipo:
Review
Páginas:
2091-2107
PubMed:
32801618
Factor de Impacto:
1,025 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 12

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Keywords

  • DME, ILUVIEN, diabetic macular edema, fluocinolone acetonide implant therapy

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