Pharmaceutics
A Shorter Switching Interval from Intravitreal Dexamethasone Implant to Intravitreal Fluocinolone Acetonide Implant Improves Clinical Outcomes in Diabetic Macular Edema
By Maxime Mouffokes, Pascal Staccini, Mathilde Gallice and 22 others.
Abstract
Background
This study aimed to evaluate whether a shorter switching interval from intravitreal dexamethasone implant (DEXi) to intravitreal fluocinolone acetonide implant (FAci) improves anatomical and functional outcomes in patients with diabetic macular edema.
Methods
This was a retrospective, multicenter, observational extension study including 260 eyes, with a mean follow-up of 141.6 ± 55.4 weeks.
Results
Prior to FAci injection, 100% of eyes had received DEXi. The mean interval between the last DEXi and the first FAci was 24.2 ± 41.6 weeks (n = 188), i.e., 0–8 weeks in 54 eyes (28.7%) and >8 weeks in 134 eyes (71.3%). Mean BCVA was comparable between patients receiving their last DEXi ≤8 weeks and those receiving it >8 weeks prior to FAci. Compared to baseline, the ≤8-week group consistently and significantly showed lower central macular thickness (CMT) values at months 1–3, 6, 7, 9–11, 14, 16, 19, and 20 (p < 0.05). At months 12 and 24, 90 (34.6%) and 117 (45.0%) eyes required additional treatments, after a median time of 118 weeks (95% CI: 87.7–191.4). In the ≤8-week group, the normalized cumulative incidence of additional treatments was 0.33 treatments per eye at week 52 and 0.72 at week 104, versus 0.66 and 1.38 in the >8-week group, respectively. Intraocular pressure (IOP) elevation incidence did not significantly differ between the ≤8-week and >8-week groups, regardless of the IOP threshold used (≥25, ≥30, or ≥35 mmHg; all p > 0.05).