Two eye treatments for serious diabetic eye condition – final draft guidance

NICE recommended aflibercept solution for injection (Eylea, Bayer Pharma), and dexamethasone intravitreal(i) implant (Ozurdex, Allergan) as possible treatment options for some people with diabetic macular oedema, in two separate pieces of final draft guidance published (2 June).

This oedema is a common complication associated with diabetic retinopathy, and the most common cause of visual impairment in people with diabetes. It develops when blood vessels in the eye are damaged by a continuously high blood sugar level, causing plasma to leak into the eye. Abnormal new blood vessels also form under the retina causing a build-up of excess fluid (oedema) in the macular, that forms the central part of the retina. The oedema impairs light perception, causing blurred vision. If it is not treated effectively, it can lead to irreversible vision loss.

The second final draft guidance, dexamethasone intravitreal implant is recommended as a treatment option in people only if:
• implant is to be used in an eye with an intraocular (pseudophakic) [ii] lens, and
• their diabetic macular oedema does not respond to non-corticosteroid(iii) treatment or such treatment is unsuitable.

Dexamethasone works by suppressing inflammation and preventing oedema forming in the eye. It reduces plasma leakage from blood vessels and inhibits the release of inflammatory compounds that cause damage to the eye.

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