Switching from Short- to Long-Term Intravitreal Corticostero
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Diabetic macular edema (DME) is the most common cause of vision loss in patients with diabetic retinopathy. With the growing prevalence of diabetes, an aging population, and the increased life expectancy of individuals with diabetes, the prevalence of DME is expected to rise. DME significantly impacts a patient's quality of life because functional ability declines at higher levels of visual impairment, and an estimated almost two-thirds of individuals with DME experience limitations in performing daily activities. A study conducted to evaluate outcomes of patients with persistent or recurrent DME who switched from a short-term (dexamethasone) to long-term (fluocinolone acetonide, FAc) corticosteroid intravitreal implant in a real-world setting.

Forty-four eyes from 36 patients were analyzed. The mean duration of DME was 3.3 ± 1.9 years, and the mean follow-up was 8 months. From baseline following FAc implantation, VA increased significantly at months 1 and 6, and the last observation carried forward. CRT improved significantly at months 1 and 6, and LOCF. MV was consistently, but not significantly, decreased from baseline to LOCF. The mean change in IOP was −0.25 and +0.88 mm Hg at months 1 and 6, respectively, and +1.86 mm Hg at LOCF. Increases were controlled with topical medication in most cases.

In conclusions
The FAc intravitreal implant is an effective treatment option for patients previously treated with the short-acting dexamethasone implant. FAc significantly improves VA and edema in patients with recurrent DME, with safety signals consistent with corticosteroid class effects. Physicians and patients, therefore, have the choice to use the FAc implant earlier in the DME treatment process should they wish, and doing so may reduce the burden of the frequency of repeated injections for both patients and clinical staff.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114907/
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