International Ophthalmology

, Volume 39, Issue 10, pp 2179–2185 | Cite as

Dexamethasone implant as an adjuvant therapy to ranibizumab loading dose in persistent diabetic macular edema

  • Akin CakirEmail author
  • Burak Erden
  • Selim Bolukbasi
  • Alper Halil Bayat
  • Seyma Gulcenur Ozturan
  • Mustafa Nuri Elcioglu
Original Paper



This study evaluates the effectiveness of a single-dose dexamethasone implant (DI) as an auxiliary therapy to continued intravitreal ranibizumab (IVR) treatment in patients with persistent diabetic macular edema (DME).


Twenty-five pseudophakic eyes of 25 patients with DME who underwent a single injection of DI as an adjuvant therapy following an IVR loading dose were examined retrospectively. All patients were treatment naive and had a poor response to a loading dose of three consecutive monthly IVR injections. IVR treatments were continued pro re nata after the DI. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 1, 3, 6 and 8 months post-DI treatment.


After the IVR loading dose, the mean BCVA and CMT were 0.9 ± 0.6 LogMAR and 478.2 ± 107.8 µm, respectively. One month after the DI, the mean BCVA and CMT had improved to 0.6 ± 0.4 LogMAR (p = 0.005) and 313.8 ± 62.7 µm (p < 0.001), respectively. This improvement was maintained with mean 0.8 ± 0.8 IVR injections throughout the follow-up period. The final mean BCVA and CMT were 0.5 ± 0.5 LogMAR and 298.4 ± 71.5 µm. Subgroup analyses revealed that different DME types did not have any effect on CMT or BCVA improvement (p = 0.188, p = 0.136; respectively).


Adding DI results in rapid anatomical and visual improvement in patients who respond poorly to an IVR loading dose. Improvements may be maintained with additional IVR in follow-up.


Dexamethasone Diabetic macular edema Adjuvant therapy 



The authors have no financial interest in any materials used in the study.

Compliance with ethical standards

Conflict of interest

None of the authors has any financial/conflicting interests to disclose.


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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of OpthalmologyOkmeydanı Research and Training HospitalIstanbulTurkey

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