TITLE:
Simultaneous Intravitreal Ranibizumab and Dexamethasone Implant Administration at the Same Setting in Eyes with Severe Diabetic Macular Edema
AUTHORS:
Ali Osman Saatci, Ziya Ayhan, Ceren Durmaz Engin
KEYWORDS:
Dexamethasone Implant, Diabetic Macular Edema, Optical Coherence Tomography, Ozurdex, Ranibizumab
JOURNAL NAME:
Open Journal of Ophthalmology,
Vol.6 No.2,
May
31,
2016
ABSTRACT: Aim: To share our experience in eyes with severe DME (exhibiting serous retinal detachment or
large cysts) treated with simultaneous intravitreal ranibizumab and dexamethasone implant administration
at the same setting as the first treatment step. Subjects and Results: Five eyes of three
patients with DME who were either treatment naive or relatively undertreated were presented in
this report. As optical coherence tomography exhibited serous retinal detachment or severe cystoid
edema with large cysts, intravitreal ranibizumab and dexamethasone implant were simultaneously
employed at the same setting as the first treatment step in those eyes. Panretinal photocoagulation
was also commenced bilaterally a week after the start of injections when at least one
eye had retinal neovascularization. Subsequent treatments of intravitreal ranibizumab and/or
dexamethasone implant were administered. Patients were followed up for seven, eight and 13
months respectively. All five eyes achieved a relative anatomic stability and experienced visual
improvement at the end of follow-up. Conclusion: In some cases with severe DME with or without
proliferative diabetic retinopathy, simultaneous intravitreal ranibizumab and dexamethasone
implant administration at the same setting may be a better option to initiate the treatment over
mono ranibizumab treatment. A randomized study comparing the mono anti-VEGF therapy and
mono dexamethasone implant administration with simultaneous treatment may outline the place
of this type of therapy in the treatment armamentarium of severe DME.