دورية أكاديمية
Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency.
| العنوان: | Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency. |
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| المؤلفون: | Adams OE; Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA.; Department of Ophthalmology and Visual Science, The University of Chicago Medicine & Biological Sciences, Chicago, IL, USA., Schechet SA; Department of Ophthalmology and Visual Science, The University of Chicago Medicine & Biological Sciences, Chicago, IL, USA., Hariprasad SM; Department of Ophthalmology and Visual Science, The University of Chicago Medicine & Biological Sciences, Chicago, IL, USA. |
| المصدر: | European journal of ophthalmology [Eur J Ophthalmol] 2021 Mar; Vol. 31 (2), pp. 612-619. Date of Electronic Publication: 2020 Jan 21. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: SAGE Publishing Country of Publication: United States NLM ID: 9110772 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6016 (Electronic) Linking ISSN: 11206721 NLM ISO Abbreviation: Eur J Ophthalmol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2018- : Thousand Oaks, CA : SAGE Publishing Original Publication: Milano ; Birmingham, AL : Wichtig, c1991- |
| مواضيع طبية MeSH: | Visual Acuity*, Diabetic Retinopathy/*drug therapy , Fluocinolone Acetonide/*administration & dosage , Macular Edema/*drug therapy, Cohort Studies ; Diabetic Retinopathy/complications ; Diabetic Retinopathy/diagnosis ; Drug Implants ; Female ; Glucocorticoids/administration & dosage ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macula Lutea/pathology ; Macular Edema/diagnosis ; Macular Edema/etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, Optical Coherence/methods |
| مستخلص: | Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and Methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti-vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre- and post-fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post-fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post-fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre-fluocinolone acetonide, to one every 2.8 months post-fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients. |
| فهرسة مساهمة: | Keywords: Diabetic macular edema; diabetic retinopathy; medical therapies; pharmacology; practice management; retina; socioeconomics and education in medicine/ophthalmology |
| المشرفين على المادة: | 0 (Drug Implants) 0 (Glucocorticoids) 0CD5FD6S2M (Fluocinolone Acetonide) |
| تواريخ الأحداث: | Date Created: 20200123 Date Completed: 20210628 Latest Revision: 20220423 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1177/1120672120901691 |
| PMID: | 31964171 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1724-6016 |
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| DOI: | 10.1177/1120672120901691 |