Intravitreal dexamethasone implant combined with bevacizumab versus intravitreal bevacizumab for diabetic macular edema

Purpose To compare the visual and anatomical outcomes of intravitreal bevacizumab combined with the dexamethasone intravitreal implant and bevacizumab monotherapy in eyes with diabetic macular edema Methods We retrospectively reviewed 41 eyes of 41 patients with diabetic macular edema who underwent either intravitreal bevacizumab (1.25 mg) (20 eyes, IVB group) injection alone or simultaneous injection of bevacizumab (1.25 mg) and dexamethasone implant (0.7 mg) (21 eyes, IVD group). The best‐corrected visual acuity, central macular thickness (CMT), intraocular pressure, and retreatment percentages were accessed for 1, 3, and 6 months after injection Results At 3 and 6 months, best‐corrected visual acuity (BCVA) showed significant improvements in the IVD group compared to the baseline. No significant improvement of the BCVA was observed in the IVB group during the initial 3 months; however, BCVA in this group at 6 months was significantly improved compared to baseline. There was a significant improvement in CMT in IVD group compared to IVB group during the first 3 months. In IVD group, CMT was 264.39 ± 54.95 µm at 1 month after initial injection while that of IVB group was 349.00 ± 112.18 µm (p = 0.011). At 3 months, CMT in the IVD group significantly improved compared to that of IVB group (p < 0.001). The average number of additional intravitreal injections during 6 months follow‐up period was 0.45 in the IVD group and 1.15 in the IVB group. In the IVD group, cortical (7%) and posterior subcapsular (15%) cataract developed by 2 grades or more during the follow‐up period in phakic eyes. Conclusions In patients with diabetic macular edema, simultaneous therapy combining a dexamethasone implant plus bevacizumab showed significant improvement in the visual acuity and CMT during the initial 3 months, and the number of additional intravitreal injections were less in combined treated group.