November 2018 Image of the Month

Image of the Month, a recurring feature in Retinal Physician since 2006, spotlights diagnostic images captured by industry practitioners using innovative technology and diagnostic instruments.

A Suprachoroidal ILUVIEN® Implant for Treatment of Chronic Diabetic Macular Edema



This is a patient with Chronic Diabetic Macular Edema. The patient received several anti VEGF injections; the need of reinjection was a problem. The patient was treated by a suprachoroidal ILUVIEN® implant. The implant is a slow release device that releases fluocinolone acetonide at an initial rate of 0.25 μg/day (average rate 0.2 μg/day) and lasts 36 months. The implant is designed for intravitreal injection. We implanted the device in the suprachoroidal space in part of a trial to see if this would have an effect on controlling the macular edema, and at the same time minimizing or preventing the long term effect of steroids on the eye seen from intravitreal exposure as Cataract and Glaucoma. The trial was based on our previous studies that showed the therapeutic effect of suprachoroidal Triamcinolone efficacy.

The implant was placed in the suprachoroidal space using a sclerotomy created 4mm behind the limbus. The implant was placed in a special designed catheter to inject it in the suprachoroidal space below the disk with the releasable end towards the macula. Color photography as well as OCT show and confirm the suprachoroidal placement of the implant.

The opinions, ideas, views and assumptions expressed are the author's own and do not necessarily represent the views of Topcon, nor do they constitute advice from Topcon.

1. OCT Angiography is not available for sale in the U.S.

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