Skip to main content
main-content

01.11.2011 | Retinal Disorders | Ausgabe 11/2011

Graefe's Archive for Clinical and Experimental Ophthalmology 11/2011

Subconjunctival sirolimus in the treatment of diabetic macular edema

Zeitschrift:
Graefe's Archive for Clinical and Experimental Ophthalmology > Ausgabe 11/2011
Autoren:
Nupura Krishnadev, Farzin Forooghian, Catherine Cukras, Wai Wong, Leorey Saligan, Emily Y. Chew, Robert Nussenblatt, Frederick Ferris III, Catherine Meyerle

Abstract

Background

Diabetic macular edema (DME) is a leading cause of blindness in the developed world. Sirolimus has been shown to inhibit the production, signaling, and activity of many growth factors relevant to the development of diabetic retinopathy. This phase I/II study assesses the safety of multiple subconjunctival sirolimus injections for the treatment of DME, with some limited efficacy data.

Methods

In this phase I/II prospective, open-label pilot study, five adult participants with diabetic macular edema involving the center of the fovea and best-corrected ETDRS visual acuity score of ≤74 letters (20/32 or worse) received 20 μl (440 μg) of subconjunctival sirolimus at baseline, month 2 and every 2 months thereafter, unless there was resolution of either retinal thickening on OCT or leakage on fluorescein angiography. Main outcome measures included best-corrected visual acuity and central retinal thickness on OCT at 6 months and 1 year, as well as safety outcomes.

Results

Repeated subconjunctival sirolimus injections were well-tolerated, with no significant drug-related adverse events. There was no consistent treatment effect related to sirolimus; one participant experienced a 2-line improvement in visual acuity and 2 log unit decrease in retinal thickness at 6 months and 1 year, two remained essentially stable, one had stable visual acuity but improvement of central retinal thickness of 1 and 3 log units at 6 months and 1 year respectively, and one had a 2-line worsening of visual acuity and a 1 log unit increase in retinal thickness at 6 months and 1 year. Results in the fellow eyes with diabetic macular edema, not treated with sirolimus, were similar.

Conclusions

Subconjunctival sirolimus appears safe to use in patients with DME. Assessment of possible treatment benefit will require a randomized trial.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de. Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 11/2011

Graefe's Archive for Clinical and Experimental Ophthalmology 11/2011 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

01.08.2019 | Erkrankungen der Hornhaut | CME | Ausgabe 8/2019

Neurotrophe Keratopathie

Grundlagen, Diagnostik und Therapie

22.07.2019 | DFP-Fortbildung | Ausgabe 4/2019 Open Access

Aktuelle Möglichkeiten der visuellen Rehabilitation

28.06.2019 | Neuroradiologie | CME | Ausgabe 7/2019

Neuroradiologie in der Augenheilkunde

19.06.2019 | Leitlinien, Stellungnahmen und Empfehlungen | Ausgabe 8/2019

Bewertung und Qualitätssicherung refraktiv-chirurgischer Eingriffe durch die DOG und den BVA – KRC-Empfehlungen

Stand Februar 2019