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Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients

  • Inflammatory Disorders
  • Published:
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Abstract

Purpose

To evaluate intravitreal 0.19 mg fluocinolone acetonide implant (FAi) (Iluvien®) for the treatment of chronic non-infectious uveitis with associated cystoid macular edema (CME).

Methods

A retrospective review of medical reports from a single Danish tertiary centre including 20 patients (20 eyes), treated with 0.19 mg FAi for non-infectious uveitic CME. The primary endpoints were change in best corrected visual acuity (BCVA) and central retinal thickness (CRT). The secondary endpoints were recurrence rate, change in systemic treatment, and intraocular pressure (IOP).

Results

Mean follow-up of the 20 eyes was 2.3 ± 1.1 years. BCVA improved at 6 (p = 0.13), 12 (p = 0.05), 18 (p = 0.03), and 24 months and CRT decreased at 6 (p = 0.004), 12 (p = 0.006), 18, and 24 months after 0.19 mg FAi. Within 18 months after implantation, four of 14 patients (28.6%) relapsed. Three of five patients discontinued systemic corticosteroids within 4 months and one patient continued with reduced dose. Five of 10 patients receiving disease-modifying antirheumatic drugs (DMARDs) at time of implantation discontinued within 1 year. No patients started new systemic treatment. Eight eyes were treated with topical IOP-lowering medication at the time of implantation, of these two later underwent trabeculectomy. There were no complications associated with previous glaucoma surgery.

Conclusion

This long-term follow-up study showed that intravitreal treatment with 0.19 mg FAi should be considered in the treatment of chronic non-infectious uveitic CME in selected patients. This treatment is safe even in selected glaucoma patients and may offer reduction or cessation of local or systemic anti-inflammatory treatment.

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Data availability

The datasets generated and analyzed are available from the corresponding author on request.

Code availability

Not applicable.

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Acknowledgements

The authors wish to thank PhD Student, MSc Optometry, Signe Krejberg Jeppesen for her assistance with the statistical methods used.

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Authors and Affiliations

  1. Department of Ophthalmology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 167, 8200, Aarhus N, Denmark

    Anne Studsgaard, Kåre Ørts Clemmensen & Mette Slot Nielsen

Authors
  1. Anne Studsgaard
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  2. Kåre Ørts Clemmensen
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  3. Mette Slot Nielsen
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Contributions

M.N. conceived the idea of analyzing the results. A.S. collected the data, performed the analysis, and wrote the manuscript. M.N. and K.C. verified the analytical methods, provided critical feedback, and helped shape the final manuscript.

Corresponding author

Correspondence to Anne Studsgaard.

Ethics declarations

Ethical approval

All procedures performed were in accordance with the ethical standards of the Department of Ophthalmology, Aarhus University Hospital, Denmark, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent to treatment with Iluvien® was obtained from all individual participants included in the study.

Consent for publication

Not applicable (treatment quality assessment).

Conflict of interest

The authors declare no competing interests.

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Studsgaard, A., Clemmensen, K.Ø. & Nielsen, M.S. Intravitreal fluocinolone acetonide 0.19 mg (Iluvien®) for the treatment of uveitic macular edema: 2-year follow-up of 20 patients. Graefes Arch Clin Exp Ophthalmol 260, 1633–1639 (2022). https://doi.org/10.1007/s00417-021-05504-6

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  • DOI: https://doi.org/10.1007/s00417-021-05504-6

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