Steroid eye drop treatment (difluprednate ophthalmic emulsion) is effective in reducing refractory diabetic macular edema

Nakano, Shoko; Yamamoto, Tohru; Kirii, Eriko; Abe, Sachi; Yamashita, Hidetoshi

doi:10.1007/s00417-010-1316-y

Cited by 48 publications

(36 citation statements)

References 14 publications

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“…A non-randomized clinical study for refractory DME after vitrectomy, with eye-drops of difluprednate emulsion (Durezol™, Alcon Laboratories, Inc.), approved by FDA for the treatment of inflammation and pain associated ocular surgery, was conducted to compare with sub-tenon's injection of TA [154]. In the eye-drops group (11 eyes in 7 patients), mean retinal thickness measured by OCT decreased from 500.6 ± 207.7 m at baseline to 341.2 ± 194.8 m at 3 month.…”

Section: Eye-dropsmentioning

confidence: 99%

Recent Advances in Ocular Drug Delivery Systems

2011

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Abstract:Transport of drugs applied by traditional dosage forms is restricted to the eye, and therapeutic drug concentrations in the target tissues are not maintained for a long duration since the eyes are protected by a unique anatomy and physiology. For the treatment of the anterior segment of the eye, various droppable products to prolong the retention time on the ocular surface have been introduced in the market. On the other hand, direct intravitreal implants, using biodegradable or non-biodegradable polymer technology, have been widely investigated for the treatment of chronic vitreoretinal diseases. There is urgent need to develop ocular drug delivery systems which provide controlled release for the treatment of chronic diseases, and increase patient's and doctor's convenience to reduce the dosing frequency and invasive treatment. In this article, progress of ocular drug delivery systems under clinical trials and in late experimental stage is reviewed.

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Section: Eye-dropsmentioning

confidence: 99%

Recent Advances in Ocular Drug Delivery Systems

2011

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“…In addition, difluprednate is administered in an emulsion, thus increasing its bioavailability 4. The dose uniformity of difluprednate ophthalmic emulsion 0.05% was highly predictable compared with both branded and generic prednisolone (shaken or unshaken) acetate suspensions 6. Similar to other corticosteroids, difluprednate may cause a steroid-responsive intraocular pressure rise; however, its effect is minimal compared with other drugs in its class 10…”

Section: Discussionmentioning

confidence: 99%

“…In patients with persistent CME, intravitreal injections of bevacizumab or triamcinolone have been used with success 1,2. In this case report, we describe rapid resolution of pseudophakic CME documented with spectral domain optical coherence tomography (SD-OCT, Spectralis ® , Heidelberg Engineering Inc, Carlsbad, CA) after topical administration of difluprednate 0.05% (Durezol ® , Sirion Therapeutics, Tampa, FL), a fluorinated corticosteroid with reportedly greater intraocular penetration 3–6…”

Section: Introductionmentioning

confidence: 98%

Spectral domain optical coherence tomography documented rapid resolution of pseudophakic cystoid macular edema with topical difluprednate

Chalam

Khetpal²,

Patel³

2012

OPTH

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IntroductionPseudophakic cystoid macular edema is a common cause of poor vision after cataract surgery, and topical corticosteroids and nonsteroidal anti-inflammatory drugs are used for its treatment. We investigated the effectiveness of difluprednate (Durezol®, recently approved by the US Food and Drug Administration) in the treatment of cystoid macular edema, assisted with spectral domain optical coherence tomography (SD-OCT).Case reportA 63-year-old African-American woman presented 6 weeks after uneventful cataract surgery in her left eye with decreased vision and associated distortion of the central visual field. Fluorescein angiogram and SD-OCT confirmed pseudophakic cystoid macular edema. Difluprednate was topically administered twice daily and monitored with serial imaging. Resolution was noted after 1 month of topical therapy, with improvement in visual acuity and resolution of distortion.ConclusionDifluprednate is an effective treatment for patients with severe pseudophakic cystoid macular edema. SD-OCT allows the physician to monitor resolution of the macular edema easily.

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“…Periocular therapies have been evaluated with limited or no visual efficacy, 4, 5 but the advent of intravitreal therapies has induced a paradigm shift. 6, 7 Mechanisms of retinal vascular leakage have been better understood at a basic science level 8, 9 and found to be clinically pertinent in DME, BRVO, and CRVO.…”

Section: Introductionmentioning

confidence: 99%

Economic Considerations of Macular Edema Therapies

Smiddy¹

2011

Ophthalmology

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Purpose To relate costs and treatment benefits for macular edema due to diabetes (DME) and branch and central retinal vein occlusion (BRVO, CRVO). Design A model of resource utilization, outcomes, and cost effectiveness and utility. Participants none Methods Results from published clinical trials (index studies) of laser, intravitreal corticosteroids, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and vitrectomy trials were used to ascertain visual benefit and clinical protocols. Calculations followed from the costs of one year of treatment for each treatment modality and the visual benefits as ascertained. Main Outcome measures Visual acuity (VA) saved, cost of therapy, cost per line saved, cost per line-year saved, and costs per quality adjusted life years (QALYs). Results The lines saved for DME (0.26 to 2.02), BRVO (0.74 to 4.92), and CRVO (1.2 to 3.75) yielded calculations of costs/line of saved VA for DME ($1329 to 11609), BRVO ($494 to 13039), and CRVO ($704 to 7611), costs/line-year for DME ($60 to 561), BRVO ($25 to 754), and CRVO ($45 to 473), and costs/QALY of $824 to $25566. Conclusion Relative costs and benefits should be considered in perspective when applying and developing treatment strategies.

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Steroid eye drop treatment (difluprednate ophthalmic emulsion) is effective in reducing refractory diabetic macular edema

Abstract: Comparable improvements of retinal thickness were observed in the STTA and eye drop groups. Instillation of difluprednate ophthalmic emulsion 0.05% is a safe and effective treatment that does not require surgical intervention and does not produce severe side-effects.

Cited by 48 publications

References 14 publications

Recent Advances in Ocular Drug Delivery Systems

Recent Advances in Ocular Drug Delivery Systems

Spectral domain optical coherence tomography documented rapid resolution of pseudophakic cystoid macular edema with topical difluprednate

Economic Considerations of Macular Edema Therapies

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