Role of Combined Therapy of Intravitreal Ranibizumab and Dexamethasone in Refractory Diabetic Macular Edema: a Retrospective Study

Abstract

Aim: To evaluate the role of intravitreal Ranibizumab injection at monthly interval for six doses along with single dose of intravitreal dexamethasone implant at first sitting of Ranibizumab in patients with refractory diabetic macular edema (DME). Methodology: Thirty eyes of 30 patients were selected in our Malda medical college with refractory DME. After proper history taking and required systemic examinations, each patient underwent detailed ophthalmic examination, including best corrected visual acuity (BCVA), intraocular pressure measurement, slit lamp examination, fundal evaluation by indirect ophthalmoscopy, 78D, 90D lens. Spectral domain optical coherence tomography (SD-OCT) has been used to evaluate central macular thickness (CMT) in each patient. After proper informed consent, 0.05 mg Ranibizumab along with 0.7 mg dexamethasone implant were injected intravitreally in each patient at first sitting, followed by intravitreal Ranibizumab for five more doses at one month interval, and all baseline investigations were repeated at one month after the first sitting as well as one month after the last dose of intravitreal Ranibizumab. Results:Postoperatively, 21 patients out of 30 had shown encouraging results as far as both improvement in BCVA and reduction in central macular thickness (CMT) were concerned. Conclusion:Intravitreal Ranibizumab combined with intravitreal dexamethasone implant might be a useful tool to deal with refractory diabetic macular edema (DME).

TABLE 1.

Mean, standard deviation, correlation coefficient in relation to BCVA

TABLE 2.

Mean, standard deviation, correlation of coefficient in relation to CMT

TABLE 3.

T test value and P value by paired T test in relation to BCVA

TABLE 4.

T test value and P value by paired T test in relation to CMT