Intravitreal Fluocinolone Acetonide May Decelerate Diabetic Retinal Neurodegeneration

Stephanie K Lynch; Kyungmoo Lee; Zhi Chen; James C Folk; Ursula Schmidt-Erfurth; Bianca S Gerendas; Andreas Wahle; Charles C Wykoff; Michael D Abràmoff

doi:10.1167/iovs.18-24643

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Intravitreal Fluocinolone Acetonide May Decelerate Diabetic Retinal Neurodegeneration

Journal article

Open access

Peer reviewed

Intravitreal Fluocinolone Acetonide May Decelerate Diabetic Retinal Neurodegeneration

Stephanie K Lynch, Kyungmoo Lee, Zhi Chen, James C Folk, Ursula Schmidt-Erfurth, Bianca S Gerendas, Andreas Wahle, Charles C Wykoff and Michael D Abràmoff

Investigative ophthalmology & visual science, Vol.60(6), pp.2134-2139

05/01/2019

DOI: 10.1167/iovs.18-24643

PMCID: PMC6528841

PMID: 31100106

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Abstract

There is no prevention or treatment for diabetic retinal neurodegeneration (DRN), which is a complication of diabetes that can occur independently of diabetic retinopathy (DR). We hypothesized that an intravitreal fluocinolone acetonide (FAc) implant may affect the rate of DRN when used in patients with diabetic macular edema (DME). In this retrospective analysis, optical coherence tomography with neuroretinal analysis was obtained at 3-month intervals from 130 patients in the USER study both before (mean duration 903 days, range 35-4005 days) and after administration of FAc (mean 408 days, range 7 to 756 days). The rate of DRN was defined as the change over time on inner neuroretinal thickness using logistic regression. A DRN rate was calculated independently for two areas: region 1 located within 1.5 mm of the fovea, and region 2 from 1.5 mm to 3.0 mm from the fovea. In regions of the macula more than 1.5 mm from the central fovea, there was a statistically significant decrease in the rate of DRN in the post-FAc period. The pre-FAc neuroretinal loss in this area occurred at 4.0 μm/y, compared with a post-FAc loss rate of 1.1 μm/y (P = 0.001). This retrospective study suggests that FAc may decelerate the rate of inner retinal thinning in patients with persistent DME. Further prospective studies are necessary to determine the effects of FAc on the rate of DRN in patients with DME.

Diabetic Retinopathy - drug therapy

Fluocinolone Acetonide - administration & dosage

Glucocorticoids - administration & dosage

Intravitreal Injections

Retinal Degeneration - drug therapy

Tomography, Optical Coherence

Humans

Middle Aged

Logistic Models

Male

Pilot Projects

Macular Edema - drug therapy

Anti-Inflammatory Agents - administration & dosage

Female

Aged

Retrospective Studies

Details

Title: Subtitle: Intravitreal Fluocinolone Acetonide May Decelerate Diabetic Retinal Neurodegeneration
Creators: Stephanie K Lynch - Department of Ophthalmology and Visual Sciences, University of Iowa, Carver College of Medicine, Iowa City, Iowa, United States
Kyungmoo Lee - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
Zhi Chen - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
James C Folk - IDx, Coralville, Iowa, United States
Ursula Schmidt-Erfurth - Department of Ophthalmology and Optometry, Vienna Reading Center, Medical University of Vienna, Vienna, Austria
Bianca S Gerendas - Department of Ophthalmology and Optometry, Vienna Reading Center, Medical University of Vienna, Vienna, Austria
Andreas Wahle - Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, United States
Charles C Wykoff - Retina Consultants of Houston, Blanton Eye Institute, Houston, Texas, United States
Michael D Abràmoff - Veterans Affairs Medical Center, Iowa City, Iowa, United States
Resource Type: Journal article
Publication Details: Investigative ophthalmology & visual science, Vol.60(6), pp.2134-2139
DOI: 10.1167/iovs.18-24643
PMID: 31100106
PMCID: PMC6528841
NLM abbreviation: Invest Ophthalmol Vis Sci
ISSN: 0146-0404
eISSN: 1552-5783
Publisher: United States
Grant note: R01 EY017066 / NEI NIH HHS R01 EY018853 / NEI NIH HHS R01 EY019112 / NEI NIH HHS I01 CX000119 / CSRD VA
Language: English
Date published: 05/01/2019
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Radiation Oncology; Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
Record Identifier: 9984060665602771

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