Combination Treatment Effective, Safe in Persistent Diabetic Macular Edema

Ophthalmologist analyzing exam’s results in a monitor
The study suggests patients treated with both agents demonstrated long-lasting visual efficacy.

At 3 months follow-up, combined simultaneous intravitreal dexamethasone and bevacizumab were safe and effective in treating persistent diabetic macular edema (DME), according to a study in Journal Français d’Ophtalmologie.

The single-center prospective nonrandomized study looked at 65 eyes of 59 patients with persistent DME divided into 2 groups. Group 1 consisted of 35 eyes of 29 persistent DME patients that received a simultaneous combination of intravitreal dexamethasone and bevacizumab, and group 2 was a control group of 30 eyes of 30 patients treated with only intravitreal bevacizumab. The investigator measured changes in best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at the first visit and each subsequent follow-up visit at the first, second, and third months recorded.

The investigator found that in group 1, mean baseline Early Treatment Diabetic Retinopathy Score (ETDRS) was 44.1±19.3 (range 20 to 51) and improved significantly to 58.8±18.2 (range 42 to 73) at month 1 (P <.05), 57±19.2 (range 40 to 72) at month 2 (P <.05), and 55.4±18.4 (range 34 to 71) at month 3 (P <.05). For group 2, mean ETDRS letter score before treatment was 43.3±18.8 (range 20 to 56), not improving significantly. By the third month, the letter score was 44.3±18.1 (range 20 to 49). 

“In group 1, the mean BCVA change from baseline to the 3rd month was 11.3 ETDRS letters,” according to the  research. “In group 2, the mean BCVA change from baseline to the 3rd month was 1 ETDRS letter. In group 1, the mean reduction in CMT from baseline was -142.25 μm. In group 2, the mean reduction in CMT from baseline was -17.30 μm. In group 1 at the third month, 12 (34.2%) eyes with a CMT >300 μm needed an additional injection.”

No patient had a serious ocular or systemic side effect.

The study’s limitations were its small number of patients, short follow-up of 3 months, and nonrandomized style.


Limon U. Early effect of simultaneous intravitreal dexamethasone and bevacizumab combination treatment in patients with persistent diabetic macular edema. J Fr Ophtalmol. Published online April 8, 2021. doi:10.1016/j.jfo.2020.08.033.