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Originally Posted On: https://iluvien.com/articles/corticosteroids-as-a-dme-treatment/
What is Diabetic Macular Edema?
Diabetic macular edema, or DME, is an eye condition that occurs as a complication of diabetic retinopathy, an eye disease that can develop in individuals with diabetes. Inflammation from persistently high blood sugar levels may lead to swelling in the macula, which is the central most part of the retina or back of the eye. DME results from the leakage of fluids from damaged blood vessels which cause swelling (or edema) in the macula. Some common symptoms of DME include the following:
- Blurry vision
- Double vision
- Wavy lines
- Dull, washed-out colors
- Loss of vision
If left untreated, DME can lead to vision problems or blindness. For those with diabetes, it is important to get at least yearly eye checkups as a preventative measure. Don’t wait until you have symptoms to protect your vision.
Potential Treatments for DME
Macular laser photocoagulation is a type of laser surgery used to treat DME, among other eye conditions. As previously mentioned, DME affects the macula, which is responsible for the detailed vision in the center of one’s visual field. DME harms the macula and the blood vessels causing the accumulation of fluid. The laser seals off the abnormal blood vessels to help prevent further leakage and edema.
Anti-VEGF treatments for DME involve an injection into the eye. Patients with retinal conditions can lose central vision due to abnormal blood vessels leaking in the retina. A series of injections of anti-VEGF medicines are administered to the eye to halt blood vessels from growing and to aid in controlling leakages. This treatment is effective in preserving central vision in many patients.
In conjunction with macular laser photocoagulation and anti-VEGF treatment, corticosteroid treatment is also available to DME patients. Steroid injections have been proven to aid in symptom relief soon after the procedure takes place. There are two approved options for DME patients receiving steroid treatment. The first is a single, high-dose injection to treat DME over the course of a few months, while the second option provides a lower dosage of steroid treatment continuously and consistently for up to 36-months with a single injection.
ILUVIEN® (fluocinolone acetonide intravitreal implant) 0.19 mg
ILUVIEN is indicated for the treatment of diabetic macular edema (DME) in patients who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in intraocular pressure.
ILUVIEN with CONTINUOUS MICRODOSINGTM Delivery was evaluated in two prospective, randomized, multicenter, double-masked, parallel 3-year studies (FAME A and FAME B). In these ILUVIEN Phase 3 clinical trials, there was a sustained improvement in visual acuity (VA) and retinal edema for up to 3 years. The most common adverse reactions reported were cataract development (ILUVIEN 82%; sham 50%) and intraocular pressure elevation of ≥ 10 mmHg (ILUVIEN 34%; sham 10%). In FAME, 4.8% of patients required incisional IOP-lowering surgery.
In recent years, the real-world, phase 4, observational PALADIN study evaluated the long-term safety of ILUVIEN in patients battling DME. From that study, there were several compelling results, including:
- IOP response with ILUVIEN was predictable, stable, and manageable.
- ILUVIEN significantly reduced retinal edema and retinal thickness variability, demonstrating management of the inflammation that causes DME.
- Patients on ILUVIEN benefited from fewer DME treatments, on average, throughout the 36-month follow-up period with 25% requiring no additional treatments.
- ILUVIEN patients maintained or improved their vision. Better visual outcomes were seen in patients who were treated earlier in their DME treatment regimen.
On average, patients who were treated with ILUVIEN saw significant improvements in their DME symptoms. The earlier that their DME treatment began, the better their results were. Click here for more details on the PALADIN results.
We hope the information in this article was helpful, but we encourage you to speak with your eye doctor about the best treatment options for you. For additional resources, please visit iluvien.com, and watch this video from a DME patient on his experience with the early use of steroids to treat DME.
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