Macular oedema
Drug safety update
August 2017: Corticosteroids: rare risk of central serous chorioretinopathy with local as well as systemic administration
NICE Guidance
See drug specific guidance below
Dexamethasone intravitreal implant is recommended as an option for the treatment of macular oedema following branch or central retinal vein occlusion and for treating visual impairment caused by diabetic macular oedema in adults only if their condition has not responded well enough to, or if they cannot have non-corticosteroid therapy. It is for specialist use only and is prescribed according to NICE TA 824.
Fluocinolone acetonide intravitreal implant is recommended as an option for treating chronic diabetic macular oedema that is insufficiently responsive to available therapies. It is for specialist use only and is prescribed according to NICE TA 953.
Other drugs used for the treatment of macular oedema include aflibercept, faricimab and ranibizumab according to NICE guidance. Faricimab is also approved for treating visual impairment caused by macular oedema after retinal vein occlusion as per NICE TA1004. A bluteq form is required for funding.
Triamcinolone acetonide preservative-free (Intracinol) is approved for vitreous visualisation during intraocular surgery and unlicensed (off label) use where necessary in macular oedema and non-infectious ocular inflammation.
