A Shorter Switching Interval from Intravitreal Dexamethasone Implant to Intravitreal Fluocinolone Acetonide Implant Improves Clinical Outcomes in Diabetic Macular Edema

Background: This study aimed to evaluate whether a shorter switching interval from intravitreal dexamethasone implant (DEXi) to intravitreal fluocinolone acetonide implant (FAci) improves anatomical and functional outcomes in patients with diabetic macular edema. Methods: This was a retrospective, multicenter, observational extension study including 260 eyes, with a mean follow-up of 141.6 ± 55.4 weeks. Results: Prior to FAci injection, 100% of eyes had received DEXi. The mean interval between the last DEXi and the first FAci was 24.2 ± 41.6 weeks (n = 188), i.e., 0–8 weeks in 54 eyes (28.7%) and >8 weeks in 134 eyes (71.3%). Mean BCVA was comparable between patients receiving their last DEXi ≤8 weeks and those receiving it >8 weeks prior to FAci. Compared to baseline, the ≤8-week group consistently and significantly showed lower central macular thickness (CMT) values at months 1–3, 6, 7, 9–11, 14, 16, 19, and 20 (p < 0.05). At months 12 and 24, 90 (34.6%) and 117 (45.0%) eyes required additional treatments, after a median time of 118 weeks (95% CI: 87.7–191.4). In the ≤8-week group, the normalized cumulative incidence of additional treatments was 0.33 treatments per eye at week 52 and 0.72 at week 104, versus 0.66 and 1.38 in the >8-week group, respectively. Intraocular pressure (IOP) elevation incidence did not significantly differ between the ≤8-week and >8-week groups, regardless of the IOP threshold used (≥25, ≥30, or ≥35 mmHg; all p > 0.05). Conclusions: A shorter interval between DEXi and FAci was associated with greater and sustained macular drying, along with a reduced need for additional treatments.

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Journal
Pharmaceutics
Published
2026-10-28
DOI
https://doi.org/10.3390/pharmaceutics18111383
Primary Topic
Retinal Diseases and Treatments
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article
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article

A Shorter Switching Interval from Intravitreal Dexamethasone Implant to Intravitreal Fluocinolone Acetonide Implant Improves Clinical Outcomes in Diabetic Macular Edema

Alban Comet, Jean‐Baptiste Conart, Stéphanie Baillif, Aude Danan et al.
2 links
Pharmaceutics
Retinal Diseases and Treatments
article

A Shorter Switching Interval from Intravitreal Dexamethasone Implant to Intravitreal Fluocinolone Acetonide Implant Improves Clinical Outcomes in Diabetic Macular Edema

Alban Comet, Jean‐Baptiste Conart, Stéphanie Baillif, Aude Danan, Laurence Rosier, Catherine P Creuzot-Garcher, David Gaucher, Mathilde Gallice, Mounir Benzerroug, Thi Hà Châu Tran, Sophie Navarre, Rita Soyeur, Bénédicte Dupas, Laurent Kodjikian, Marie‐Laure Le Lez, F. Matonti, Pascal Staccini, Vincent Gualino, Marie‐Noëlle Delyfer, Amélie Lecleire-Collet, Corinne Dot, Sophie Bonnin, Pierre-Yves Mérité, Loic Pinsard, Maxime Mouffokes, Brice Dugas, Matthieu Poupardin, Samira Hamid, Pascale Genin
article en

Abstract

Background: This study aimed to evaluate whether a shorter switching interval from intravitreal dexamethasone implant (DEXi) to intravitreal fluocinolone acetonide implant (FAci) improves anatomical and functional outcomes in patients with diabetic macular edema. Methods: This was a retrospective, multicenter, observational extension study including 260 eyes, with a mean follow-up of 141.6 ± 55.4 weeks. Results: Prior to FAci injection, 100% of eyes had received DEXi. The mean interval between the last DEXi and the first FAci was 24.2 ± 41.6 weeks (n = 188), i.e., 0–8 weeks in 54 eyes (28.7%) and >8 weeks in 134 eyes (71.3%). Mean BCVA was comparable between patients receiving their last DEXi ≤8 weeks and those receiving it >8 weeks prior to FAci. Compared to baseline, the ≤8-week group consistently and significantly showed lower central macular thickness (CMT) values at months 1–3, 6, 7, 9–11, 14, 16, 19, and 20 (p < 0.05). At months 12 and 24, 90 (34.6%) and 117 (45.0%) eyes required additional treatments, after a median time of 118 weeks (95% CI: 87.7–191.4). In the ≤8-week group, the normalized cumulative incidence of additional treatments was 0.33 treatments per eye at week 52 and 0.72 at week 104, versus 0.66 and 1.38 in the >8-week group, respectively. Intraocular pressure (IOP) elevation incidence did not significantly differ between the ≤8-week and >8-week groups, regardless of the IOP threshold used (≥25, ≥30, or ≥35 mmHg; all p > 0.05). Conclusions: A shorter interval between DEXi and FAci was associated with greater and sustained macular drying, along with a reduced need for additional treatments.

PharmaceuticsVol. 18(11)
Centre National de la Recherche Scientifique (FR), Inserm (FR), Université Côte d'Azur (FR), Université Paris Cité (FR), Centre Hospitalier Universitaire de Grenoble (FR), Centre Hospitalier Universitaire de Bordeaux (FR), Centre Hospitalier Universitaire de Nice (FR), Hôpital de la Croix-Rousse (FR), Centre Hospitalier Universitaire de Tours (FR), Centre Hospitalier Universitaire Amiens-Picardie (FR), Assistance Publique – Hôpitaux de Paris (FR), Centre Hospitalier Régional et Universitaire de Nancy (FR), Hospices Civils de Lyon (FR), Bordeaux Population Health (FR), Centre Ophtalmologique d'Imagerie et de Laser (FR), Matériaux Ingénierie et Science (FR), CHU Dijon Bourgogne (FR), Hôpital Lariboisière (FR), Hôpital Edouard Herriot (FR), Hôpital Pasteur (FR), Hôpitaux Universitaires de Strasbourg (FR), Université Toulouse - Jean Jaurès (FR), Hôpital Saint-Michel (FR), Hôpital Jean Jaurès (FR), Hôpital Albert Michallon (FR), Hôpital Civil, Strasbourg (FR), Université Grenoble Alpes (FR)
Good health and well-being
Openalex Percentile: Top 9%
Retinal Diseases and Treatments
DOIOpen Access PDFOpenAlex
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