Evaluation Of The Effectiveness Of Intravitreal Anti-VEGF Injection With Intravitreal Dexamethasone Implant In Patients With Treatment-Resistant Diabetic Macular Edema

Abstract

Purpose: To assess the effectiveness of monthly anti-VEGF therapy with an intravitreal dexamethasone (DEX) implant in patients with diabetic macular edema (DME) whose macular edema persists despite anti-VEGF therapy. Materials and methods: This study included 94 eyes of 94 patients whose diabetic macular edema (Central Macular Thickness (CMT) >300 µm) persisted despite previous injections of 3 doses of anti-VEGF. The patients were followed up at the first, second, third, and six month after intravitreal injection. Best corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) change parameters were evaluated. Results: In terms of age, proliferation, and lens status, there was no statistically significant difference between the groups. When CMT, BCVA, and IOP were assessed among the 4 groups at the end of the sixth month, no statistical difference between the groups was found. There was no need for medical intervention despite the statistically significant increase in IOP at the end of the sixth month compared to the third month in the dexamethasone implanted groups. In contrast to the decrease in CMT, which was statistically significant in all 4 groups at the end of the 6th month compared to the 3rd month, the increase in BCVA was not statistically significant in any of the 4 groups at the end of the 6th month. Conclusion: According to the results of our study, there is no superiority between continuing with existing anti-VEGF or switching to dexamethasone implant after 3 doses of anti-VEGF.