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Short term comparison results between two eyes of same individual treated with Dexamethasone implant and Ranibizumab in the management of naive Diabetic Macular Edema (DME)

Krishna Nagaradh, Prarthana Gokarn

Objective: To compare the effect of intravitreal dexamethasone implant and intravitreal Ranibizumab in paired eyes of patients with naive diabetic macular oedema.

Method: Prospectively patients with bilateral symmetrical centre involving newly diagnosed diabetic macular oedema are assigned randomly to receive intravitreal Ranibizumab monthly for three months in one eye and intravitreal dexamethosone implant in the other. During follow ups, patients were looked for functional and structural changes.

Results: Twenty eyes of ten patients were included in the study. Eyes in the dexamethasone arm showed an improvement in visual acuity from mean 0.44 to 0.13 and central foveal thickness reduced from mean 412.5 um to 255 um which was comparable to paired eye RZB arm in which vision improved from 0.48 to 0.13 and CMT from 413 um to 262 um and took one third lesser number of injections than RZB arm.

Summary: The results from our study clearly compares the effects of intravitreal Dexamethasone to intravitreal Ranibizumab and shows that patients treated with DEX implant achieved statistically significant and clinically meaningful visual improvements with lesser number of injections than RZB. Our data support the use of DEX implant as first line agent in the treatment of patients with DME.