New Drugs and New Posterior Delivery Methods in CME

Curr Ophthalmol Rep. 2017 Jun;5(2):160-168. doi: 10.1007/s40135-017-0134-3. Epub 2017 Apr 7.

Abstract

Purpose: To discuss the characteristics, indications and adverse events (AEs) of sustained-release corticosteroid devices for the treatment of cystoid macular edema (CME).

Recent findings: Ozurdex® is approved for the treatment of diabetic macular edema (DME), retinal vein occlusion related-CME and noninfectious posterior uveitis (NIPU). It releases dexamethasone over a maximum period of 6 months making repeated intravitreal injections necessary for recurrent CME. Iluvien® releases fluocinolone for up to 36 months and is effective for the treatment of chronic DME. Retisert® (Bausch & Lomb, Rochester, NY) also releases fluocinolone, and is approved for chronic NIPU. Both Iluvien® and Retisert® are non-biodegradable devices and are highly associated with cataract and glaucoma.

Summary: Long-acting intraocular corticosteroid formulations offer a more predictable drug-release profile and reduced dosing frequency in comparison to conventional formulations of the same compounds but the risk-benefit ratio must be taken into consideration previous to the implantation of those devices.

Keywords: cystoid macular edema; dexamethasone intravitreal implant; diabetic macular edema; fluocinolone acetonide; noninfectious posterior uveitis; retinal vein occlusion.