Fluticasone Acetate Implant May Improve Retinal Vein Occlusion Macular Edema

Nikisha Kothari, MD

In a new study presented at the Association for Research in Vision and Ophthalmology (ARVO) Virtual Meeting, fluticasone acetate implants were considered safe and effective in patients with macular edema due to retinal vein occlusion.

Led by Nikisha Kothari, MD, of Texas Retina Associates, an investigative team conducted a retrospective review of 13 affected eyes. All eyes received an injection with a fluticasone implant, and the investigators proceeded to evaluate central retinal thickness outcomes. They also took note of any complications, including cataract progression and increased intraocular pressure (IOP).

As such, they noted that visual acuity improved following injection, as documented in the patients’ final follow-up visit. At baseline, mean visual acuity was 0.39 versus 0.26 at final visit (P = .02).

They also observed that mean central retinal thickness improved from 412 mm at baseline to 302 mm at 6 months (P = .01). However, thickness increased to 345 mm by final follow-up (P = .3).

Further, phakic patients demonstrated cataract progression, thus leading them to require phacoemulsification surgery.

And finally, 7 patients required IOP lowering medications, and 2 patients required glaucoma filtration surgery.

“Our study found the use of the fluticasone implant to be safe and effective for the management of macular edema from retinal vein occlusion,” Kathari and team wrote. “Further larger, randomized controlled studies are required to further evaluate their efficacy.”

Related Research at ARVO

Plenty of new research coming out of this year’s conference have evaluated the safety and efficacy of implants for the treatment of ocular and retinal disorders.

As previously reported, one such study supported the efficacy of intravitreal 0.19 mg fluocinolone acetonide micro implant in patients with chronic diabetic macular edema (DME).

Data from that study showed that the implant was associated with maintenance or improvements of patients’ best-corrected visual acuity. As such, 17% of evaluated patients improved ≥15 ETDRS letters 3 months into treatment, and 33% improvements as much in 12 months.

Another study compared the efficacy of fluocinolone acetonide intravitreal implant with dexamethasone intravitreal implant in controlling inflammation due to non-infectious posterior uveitis (NIPU), showing no significant differences.

Both implants were associated with similar improvements in best-corrected visual acuity, even among patients who had switched from dexamethasone to fluocinolone acetonide.

As this study highlighted, particularly for NIPU, efficiency in use and cost of implants are important considerations for both physician and patient.

The study, “Fluticasone Intravitreal Implant in Patients with Macular Edema Due to Retinal Vein Occlusion,” was presented at ARVO 2021.