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

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

PURPOSE. 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). METHODS. 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. RESULTS. 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). CONCLUSIONS. 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.

Original languageEnglish (US)
Pages (from-to)2134-2139
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Volume60
Issue number6
DOIs
StatePublished - May 2019

Keywords

  • Diabetic neuroretinal degeneration
  • Fluocinolone acetonide (FAC) implant
  • Ganglion cell layer
  • Inner plexiform layer
  • Nerve fiber layer

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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