Authors: Alyson Evans DNP
Diabetes mellitus is an epidemic worldwide. Primary care providers, including advanced practice registered nurses, can play a vital role in both the treatment of the disease and prevention of complications, particularly diabetic macular edema. A working understanding of the disease process and early referral is of exceptional importance, as are long term treatment options patients may receive from their ophthalmologist. ILUVIEN® (fluocinolone acetonide (FAc) intravitreal implant) 0.19 mg is an implant injected into the eye (vitreous) and used for the treatment of diabetic macular edema (DME) in patients who have been previously treated with a course of corticosteroids and did not have a clinically significant increase in intraocular pressure. The implant of ILUVIEN, a corticosteroid, provides a continuous microdose of FAc for up to 36 months. One must understand the pharmacokinetics of a drug as not all corticosteroids have the same lipophilicity, water solubility and tissue penetration.as well as its lipophilic nature. The lipophilicity of FAc allows for the continuous use of a microdose that is readily absorbed into the retina, which explains why the FAc contiuous microdose can stabilize or improve vision for many patients, while reducing retinal edema. It is important for the primary care provider to appreciate the features of the drug and understand the implications of diabetic macular edema. Assertive, collaborative treatment is imperative for this patient population to maintain vision through their lifetime.
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