A 0.2 μg/day dose of a fluocinolone acetonide (FAc) intravitreal implant (Iluvien, Alimera Sciences) can be used in the treatment of vision impairment associated with chronic diabetic macular oedema (DMO) considered insufficiently responsive to available therapies1 and is approved by the National Institute for health and Care Excellence (NICE) in the United Kingdom for use in pseudophakic eyes.2
The latest data from real-life UK clinical practice show that the drug is a useful treatment option for DMO, offering visual benefits in this group of patients.3
Since the pivotal FAc Phase III clinical trials (FAME) were conducted in 2005-2011, the management of patients with chronic DMO has changed significantly. First-line treatment was traditionally focal laser photocoagulation, but this rarely resulted in an improvement in visual acuity.
Intravitreal vascular endothelial growth factor (VEGF) inhibitors are now the most widely used first-line option, and in the UK, NICE has approved their use for eyes with a central macular thickness of more than 400 μm.4,5 Monthly treatments are indicated initially, until the fluid no longer improves. The disadvantage of the VEGF treatment regimens is that numerous patient visits are required. Moreover, not all patients respond to anti-VEGF treatment.