Off-Label Use of 0.19 mg Fluocinolone Acetonide Intravitreal Implant: A Systematic Review

Autores da FMUP

• Manuel Alberto De Almeida E Sousa Falcão

  Autor

Participantes de fora da FMUP

• Ribeiro, F

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Corticosteroids are used in a variety of ophthalmological diseases. One challenge faced by ophthalmologists is to deliver corticosteroids to the posterior segment of the eye with efficacy and safety. Sustained-release corticosteroid implants may be the answer to this problem. The 0.19 mg fluocinolone acetonide (FAc) implant (Iluvien (R)) releases FAc for 36 months, and it is approved for the treatment of diabetic macular edema (DME) and noninfectious uveitis. We decided to do a systematic review to acknowledge in which other diseases FAc implant is being used off-label. A literature search was performed in the following three electronic databases: PubMed, Scopus, and Web of Science (from January 1(st), 2000, to September 20(th), 2020), using the following query: ("Fluocinolone Acetonide" OR Iluvien (R)) AND ("eye" OR "ocular" OR "intravitreal)." A total of 11 papers were included, and the use of FAc implant was analyzed in the following diseases: radiation-induced maculopathy (RM); paraneoplastic visual syndromes (melanoma-associated retinopathy (MAR) and cancer-associated retinopathy (CAR)); Sjogren's syndrome-related keratopathy; retinal vein occlusion (RVO); cystoid macular edema (CME); diabetic retinal neurodegeneration (DRN); and retinitis pigmentosa (RP). FAc implant may be a potential treatment for these diseases; however, the level of scientific evidence of the included studies in this review is limited. Further studies with larger cohorts and longer follow-ups are needed to validate this data.

Keywords

• fluocinolone acetonide; triamcinolone; best corrected visual acuity; cancer associated retinopathy; cancer associated retinopathy; diabetic macular edema; diabetic retinal neurodegeneration; diabetic retinal neurodegeneration; drug efficacy; drug safety; follow up; foveal thickness; human; intraocular pressure; keratopathy; melanoma associated retinopathy; melanoma associated retinopathy; neuroprotection; nonhuman; off label drug use; paraneoplastic visual syndrome; paraneoplastic visual syndrome; photoreceptor; radiation induced maculopathy; radiation induced maculopathy; radiation injury; recalcitrant cystoid macular edema; recalcitrant cystoid macular edema; refractory cystoid macular edema; refractory cystoid macular edema; retina degeneration; retina detachment; retina macula cystoid edema; retina maculopathy; retina vein occlusion; retinitis pigmentosa; retinopathy; Review; severe iris lens diaphragm disruption; severe iris lens diaphragm disruption; Sjoegren syndrome; Sjoegren s