Study finds optimal timing for steroid switch in DME treatment

Switching to intravitreal dexamethasone implants after 4 to 6 anti-VEGF injections yields the best visual and anatomical improvements for patients with diabetic macular edema (DME) who have not responded to initial anti-VEGF therapy, according to a study.

The study categorized 105 eyes from 77 patients with persistent DME into 3 groups based on the number of anti-VEGF injections received before the switch: Group I (3 injections), Group II (4 to 6 injections), and Group III (>6 injections).

Results showed that 46% of eyes in Group I, 50% in Group II, and 33% in Group III showed improvement after the switch. Group II demonstrated the best overall results, with 94% of eyes showing visual improvement and stabilization.

The study also found a statistically significant reduction in central retinal thickness across all groups.

Reference
Raizada S, Al Kandari J, Al Diab F, et al. Timing of Switching to Steroid Implants in Cases of Recalcitrant Diabetic Macular Edema Not Responding to Anti-vascular Endothelial Growth Factor (VEGF) Therapy: A Real-World Study. Cureus. 2024;16(6):e62385. doi: 10.7759/cureus.62385. PMID: 39006597; PMCID: PMC11246696.