Three-years single-centre outcomes in Uveitis patients treated with fluocinolone acetonide intravitreal implant (ILUVIEN®)
Purpose
ILUVIEN® is a sustained-release corticosteroid intravitreal implant (iVI) (0.2ug/day) that has been shown to reduce uveitis and uveitic macular oedema (UMO). However, close patient monitoring of implanted patients is required to monitor for ocular hypertension and glaucoma.
Methods
Uveitis patients treated with Iluvien® iVI at the Queen Elizabeth Hospital Birmingham from 2017 to 2022, were identified using the audit tool in Medisoft, EPR. Data collected from Clinical Portal (UHB EPR), Heidelberg Spectralis, and Optos included; patient demographics, type and severity of uveitis, implants used, visual outcomes [BCVA, LogMAR), central mac thickness (CMT um), max mac thickness (MMT um) and IOP mmHg)].
Results
28 cases were treated (2017-2022). 22 females; 6 males. Mean age 58.7yrs (32-85yrs). ILUVIEN® was administered on 48 occasions in 45 eyes treated (3 eyes twice) with 20 right and 25 left eyes. Uveitis duration: 8.2yrs(1-20). 33/45 eyes UME. Lens status: 11/45 phakic (6 had cataract); 33/45 pseudophakic; 1 aphakic. Baseline BCVA (LogMAR) 0.47 (1.6-0), CMT 360.6um (143-681), MMT 435.5um(223-913), IOP 12.6 mmHg(2-23). First visit post-implant, mean BCVA 0.43, CMT 291.7um, MMT 371.3, IOP 14.4mmHg. At 1-year post-implant, mean BCVA 0.38, CMT 291um; MMT 353, IOP 14.2mmHg. At 2 years, mean BCVA 0.34, CMT 259.4um, MMT 322um, IOP 13.7. 3 years, mean BCVA 0.28, CMT 243.6um, MMT 310.7um, IOP 14.8mmHg.
Conclusion
ILUVIEN® iVI uveitis patients showed improved vision and retinal thickness. IOP rise requiring medical therapy, laser or surgical intervention in 10 out of 28 cases. Iluvien® was also found to cause late onset ocular hypertension +/- Glaucoma in uveitis patients.
Conflict of interest
No
Authors 1
Last name
BALASUBRAMANIAN
Initials of first name(s)
B
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
Authors 2
Last name
Shah
Initials of first name(s)
H
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
Authors 3
Last name
Karpoor
Initials of first name(s)
M
Department
Ophthalmology
City
Wolverhampton
Country
United Kingdom
Authors 4
Last name
Agorogiannis
Initials of first name(s)
G
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
Authors 5
Last name
Denniston
Initials of first name(s)
A K
Department
Ophthalmology
City
Birmingham
Country
United Kingdom
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