ArticleInternational journal of retina and vitreous2026
Fluocinolone acetonide implant in diabetic macular edema: sustained benefits and effects of following prior therapy.
Article in International journal of retina and vitreous, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
purposeTo (1) evaluate long-term real-world anatomical and functional outcomes after implantation of a sustained-release fluocinolone acetonide (FAc) implant in eyes with diabetic macular edema (DME) and (2) to assess the influence of prior anti–vascular endothelial growth factor (anti-VEGF) and corticosteroid exposure on treatment response and durability.
methodsThis retrospective, single-center study included 74 eyes from 47 DME patients treated with intravitreal FAc implant. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP), prior treatment burden, and need for additional intravitreal therapy were evaluated over a median follow-up of 40 months. Baseline changes were analysed using paired statistical testing. Spearman correlations assessed associations between prior treatment exposure and clinical outcomes.
resultsFAc implantation significantly reduced CRT (median −75.5 µm; p<0.001). Eyes receiving fewer than six prior anti-VEGF injections demonstrated greater CRT reduction (−93 µm; p<0.001) than eyes receiving six or more injections (−65 µm; p=0.015). BCVA improved modestly overall (+3.95 ETDRS letters; p=0.037), with greater gains in less pretreated eyes (+7.53 letters; p=0.002) compared to eyes with ≥6 prior injections (+0.0 letters; p=0.492). Higher prior anti-VEGF burden correlated with shorter treatment durability (ρ = −0.35; p<0.003) and increased need for supplemental therapy (ρ = 0.30; p<0.001).
conclusionsFAc implantation provides sustained anatomical improvement and modest functional benefit in DME, particularly when introduced earlier in the treatment course. Earlier integration of long-acting corticosteroid therapy may enhance durability and reduce cumulative anti-VEGF burden.
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