Corticosteroid implant shows positive real-world outcomes in severe cases of DME
VIENNA — Real-world 3-year data from the RETRO-IDEAL study showed that advanced diabetic macular edema cases can benefit from being treated with the Iluvien fluocinolone acetonide intravitreal implant from Alimera Sciences. The study was a retrospective analysis of 100 patients treated in Germany and consisted of two groups, vitrectomized and non-vitrectomized eyes.
“Patients in both groups had diabetes and diabetic retinopathy at an advanced stage. They had generally poor health conditions, even worse in the prior vitrectomy group. Many in this group were pseudophakic, had ocular hypertension, macular ischemia, and the rate of proliferative diabetic retinopathy was higher. They had undergone more laser treatments and intravitreal injections,” Albert Augustin, MD, said at the Euretina meeting.
The reasons for changing therapy were insufficient response to treatment, pronounced edema and a high number of recurrences.
“We found no significant safety issues in the study. IOP was controlled, though the prior vitrectomy group needed a higher number of IOP-lowering medications,” Augustin said.
An impressive reduction of central retinal thickness was obtained, from 500 µm to approximately 300 µm in both groups. Overall more than two-thirds of patients had central retinal thickness below 300 µm at month 30. A gain of six letters was achieved in the non-prior vitrectomy group.
“The prior vitrectomy group gained two letters, reflecting a more long-standing retinal alteration,” Augustin said. “These patients also required a higher number of re-treatments.”
Overall, results were positive, taking into account the severity of disease.
“The treatment with Iluvien reduced the edema, and improvement or stabilization of VA was obtained in 73% of the eyes over 3 years. Non-vitrectomized eyes had better results, as expected,” Augustin said. – by Michela Cimberle
Augustin A, et al. The first report comparing 3 year outcomes of Iluvien (fluocinolone acetonide) in vitrectomized and non-vitrectomized eyes in patients with DME – results from RETRO-IDEAL. Presented at: Euretina; Sept. 20-23, 2018; Vienna.
Disclosure: Augustin reports no relevant financial disclosures.