An analysis of data from the FAME trials was undertaken to try to understand the final three-year visual and anatomic outcomes of patients treated with the fluocinolone acetonide intravitreal implant (Iluvien, Alimera Sciences) who exhibi
Retinal vein occlusions (RVOs) are a frequent cause of retinal vascular disease in patients older than 50 years.
Compared with intravitreous ranibizumab, the decreases in the plasma-free VEGF levels were greater with intravitreous aflibercept and bevacizumab in patients with diabetic macular edema.
Among a subset of patients in the phase IV PALADIN study, there was improved visual acuity, improved macular thickness, and reduced treatment burden among patients treated with the intravitreal fluocinolone acetonide 0.2 µg (Iluvien implant) for DME.
The addition of dexamethasone implant (Ozurdex, Allergan) to a continuing regimen of ranibizumab (Lucentis, Genentech) did not produce results in visual acuity outcomes that differed from those achieved with ranibizumab alone at 6 months. However, there was an improvement in the central macular thickness on OCT in patients.
The use of aflibercept led to greater improvement in macular perfusion status in a phase III trial with DME patients. Those with baseline nonperfusion tended to have more advanced disease.
There is subset of patients with resistant or persistent DME that forms the impetus for new treatment strategies, including next-generation anti-VEGF-A and new classes of drugs. Pravin U. Dugel, MD, outlines a list of potential treatment candidates that may lead that paradigm shift.
Maurice B. Landers III, MD, presents an argument that in an era when pharmacological therapy has become the mainstay for the treatment of diabetic macular edema (DME), pars plana vitrectomy (PPV) deserves consideration as a reasonable alternative for early DME in appropriate patients.
Partner Perspective: Patient Case Study - CONTINUOUS MICRODOSING™ TREATMENT WITH ILUVIEN® (fluocinolone acetonide intravitreal implant) 0.19mg
Results of the prospective TREX-DME study provide an evidence base for using a treat-and-extend protocol for administering anti-VEGF injections for eyes with diabetic macular edema.