title: Dexamethasone Intravitreal Implant as Adjunctive Therapy to Ranibizumab in Neovascular Age-Related Macular Degeneration: A Multicenter Randomized Controlled Trial.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of dexamethasone intravitreal implant 0.7 mg (DEX) as adjunctive therapy to ranibizumab in neovascular age-related macular degeneration (nvAMD).
  
  
  METHODS
  This was a 6-month, single-masked, multicenter study. Patients were randomized to DEX implant (n = 123) or sham procedure (n = 120) and received 2 protocol-mandated intravitreal ranibizumab injections. The main outcome measure was injection-free interval to first as-needed ranibizumab injection.
  
  
  RESULTS
  DEX increased the injection-free interval versus sham (50th percentile, 34 vs. 29 days; 75th percentile, 85 vs. 56 days; p = 0.016). 8.3% of DEX versus 2.5% of sham-treated patients did not require rescue ranibizumab (p = 0.048). Visual acuity and retinal thickness outcomes were similar in DEX and sham-treated patients. Only reports of conjunctival hemorrhage (18.2 vs. 8.5%) and intraocular pressure elevation (13.2 vs. 4.2%) were significantly different in the DEX versus the sham treatment groups.
  
  
  CONCLUSIONS
  DEX reduced the need for adjunctive ranibizumab treatment and showed acceptable tolerability in nvAMD patients.
authors.affiliation: Gavin Herbert Eye Institute, University of California Irvine, Irvine, Calif., USA.
authors.forename: Baruch D
authors.initials: BD
authors.lastname: Kuppermann
authors.forename: Michaella
authors.initials: M
authors.lastname: Goldstein
authors.forename: Raj K
authors.initials: RK
authors.lastname: Maturi
authors.forename: Ayala
authors.initials: A
authors.lastname: Pollack
authors.forename: Michael
authors.initials: M
authors.lastname: Singer
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
authors.forename: Dov
authors.initials: D
authors.lastname: Weinberger
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Li
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Liu
authors.forename: Jean
authors.initials: J
authors.lastname: Lou
authors.forename: Scott M
authors.initials: SM
authors.lastname: Whitcup
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab