To assess the effect of intravitreal dexamethasone (DEX) 0,7 mg implant (Ozurdex) in patients with chronic diabetic macular edema resistant to prior intravitreal (IV) monthly 5 dose Ranibizumab.

Materials & Methods:

Twenty five eyes of 24 patients were included the study. Before and after IV DEX implant visual acuity, central macular thickness (CMT) and intraocular pressure (IOP) were assessed monthly for 6 months. All patients had a CMT over 300 µm and were unresponsive to 5 monthly IV Ranibizumab injections.


The visual acuity increased 1-2 Snellen lines in 22 (88%) eyes and 3-4 Snellen lines in 3 (22%) eyes. CMT were 496±104,90 µm before IV DEX and 346±92,54 µm after 1 month, 232±86,25 µm after 2 months, 296±75,32 µm after 3 months, 371±50,25 µm after 4 months. Decreasing CMT until 4th month statistically significant (p<0,001). All patients need second IV DEX injection at 5 months. Mean follow up was 6,5 (range 6-8) months. There were persistent IOP increases (over 25 mmHg) in 3 patients. These eyes treated with topical anti- glaucomatous (Dorsolamide %1-Timolol %0,5 fixed combination).


The slow release intravitreal DEX implant produced improvements in visual acuity and CMT until 4 th month in diabetic macular edema resistant to Ranibizumab injections. This improvement was sustained until the third month. The optimal retreatment time point is at 5th month.

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Nil İrem Uçgun