Anti-VEGF versus dexamethasone implant (Ozurdex) for the management of Centre involved Diabetic Macular Edema (CiDME): a randomized study

Abstract

Purpose: To compare the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection versus dexamethasone implant (Ozurdex) for the treatment of center-involved DME (CiDME).

Method: This prospective randomized comparative study included 40 eyes (38 patients) of CiDME. They were randomized into two groups. Patients in group A received the intravitreal anti-VEGF injection (bevacizumab 1.25 mg or ranibizumab 0.5 mg) and those in group B received dexamethasone implant (0.7 mg) pro-re-nata after 4 weeks and 3 months, respectively. The primary outcome was measured at 3 months from the baseline that included improvement in BCVA, reduction in CFT, and adverse effects during the follow-up period.

Results: Mean best-corrected visual acuity (BCVA) improved from 0.51 ± 0.275 LogMAR units (20/63) to 0.20 ± 0.185 LogMAR units (20/32) in group A and from 0.56 ± 0.213 LogMAR units (20/80) to 0.141 ± 0.177 LogMAR units (20/32) in group B at 3 months. There was no significant difference in mean BCVA between both the groups (p = .27). The mean central foveal thickness (CFT) improved from 443.55 ± 131.536 µ to 277.66 ± 76.184 µ and from 460.95 ± 125.462 µ to 233.25 ± 37.552 µ at 3 months in group B (p = .02).

Conclusion: Both the groups had the similar visual outcome. However, the superior anatomical result was observed in dexamethasone implant group during this short follow-up.

Keywords: Anti-VEGF; Centre involved diabetic macular edema (CiDME); Ozurdex implant.