PU Conference Series: Euretina 2018

Among the parameters measured as part of the study were visual acuity, central foveal thickness (µm) and intraocular pres- sure (IOP; mm Hg). As well, DME therapies were recorded for the purposes of com- parison of the intravitreal drugs utilized in the 12 months before and following use of ILUVIEN. The researchers reported that between day 0 and day 365, visual acuity and central foveal thickness worsened, with mean visual acuity declining by 3.4 letters, from 59.5 ± 17.9 letters, and central foveal thickness increasing by 58.5 µm, from 442.0 µm. At day +365, however, there was a mean increase in visual acuity of 8.7 letters, from 56.5 letters (day 0), and a decrease in central foveal thickness, from 500.8 µm to 291.6 µm. At day +365, there was also a marked reduction in edema with 66% of eyes (n=75) having a central foveal thickness < 350 µm (vs 23%, n=26, at day 0). Short-acting steroids were predominantly used to treat DME (66%of eyes, n=75) prior to ILUVIEN, and their use decreased dra- matically by day +365 (2%, n=7), although the mean number of treatments given to

Overall, the ILUVIEN implant shows prom- ise for treating diabetic macular edema and may be particularly helpful in patients with good initial visual acuity.” In 2014, the U.S. Food and Drug Administration approved ILUVIEN for the treatment of DME. It is indicated for patients who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in intraocular pressure. A single injection of the ILUVIEN micro-insert can provide sustained treatment of DME for 36 months. Approximately 560,000 peo- ple in the United States are estimated to have clinically significant DME, the most frequent cause of vision loss in individu- als with diabetes and the leading cause of blindness in young and middle-aged adults in developed countries. The provision of this information is not intended to advocate any use not covered by the Product Information. Please check that the product is approved for use and always consult the Product Information before prescribing. www.practiceupdate.com/c/73991

patients remained the same (1.3 vs 1.1; day 365 vs day +365), the researchers noted. The percentage usage of anti-VEGF agents followed a similar pattern, albeit lower overall usage in patients, with 20% of eyes requiring an anti-VEGF in the previous 12 months vs 10% by day +365 post-implant (mean injections were 2.1 vs 2.6, respectively). Post-ILUVIEN implant, emergent IOP-lowering medication was required in 14% of eyes (increasing from 38% at day 365 to 52% at day +365), and there was one case of IOP surgery. In a comment on the findings, Joseph W Sassani MD, of the Penn State Hershey Eye Center, who was not involved in the study, told Elsevier’s PracticeUpdate that, “the authors note that a unique feature of the study design was that macular edema was monitored 12 months prior to and fol- lowing ILUVIEN therapy. Following the initiation of ILUVIEN therapy, improvement was noted in visual acuity and in central foveal thickness, although the mean num- ber of other treatments did not decrease. Significantly, there was an increased need for medication to control IOP, and one patient required surgery to control IOP.

EURETINA 2018 • PRACTICEUPDATE CONFERENCE SERIES 13