Contralateral eye-to-eye comparison of intravitreal ranibizumab and a sustained-release dexamethasone intravitreal implant in recalcitrant diabetic macular edema.
OBJECTIVE
To compare the effects of intravitreal ranibizumab (RZB) or dexamethasone (DEX) intravitreal implant in cases of recalcitrant diabetic macular edema (DME).


METHODS
Retrospective, interventional study examining patients with symmetric bilateral, center-involved DME recalcitrant to treatment with RZB, who received DEX in one eye while the contralateral eye continued to receive RZB every 4-5 weeks for a study period of 3 months.


RESULTS
Eleven patients (22 eyes) were included: mean logarithm of the minimal angle of resolution (logMAR) visual acuity (VA) for the DEX arm improved from 0.415 (standard deviation [SD] ±0.16) to 0.261 (SD ±0.18) at final evaluation, and mean central macular thickness (CMT) improved from 461 µm (SD ±156) to 356 µm (SD ±110; net decrease: 105 µm, P=0.01). Mean logMAR VA for the RZB arm improved from 0.394 (SD ±0.31) to 0.269 (SD ±0.19) at final evaluation. Mean CMT improved from 421 µm (SD ±147) to 373 µm (SD ±129; net decrease: 48 µm, P=0.26).


CONCLUSIONS
A subset of recalcitrant DME patients demonstrated significant CMT reduction and VA improvement after a single DEX injection.
Department of Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
Benjamin J
BJ
Thomas
Department of Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
Yoshihiro
Y
Yonekawa
Department of Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
Jeremy D
JD
Wolfe
Department of Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
Tarek S
TS
Hassan
aflibercept; bevacizumab; central macular thickness; dexamethasone implant; diabetic macular edema; diabetic retinopathy; macular edema; ranibizumab