Therapeutic effect of simultaneous intravitreal dexamethasone and aflibercept on diabetic macular edema

Tai Chi Lin, Yu Chien Chung, Tsui Kang Hsu, Hsin Wei Huang, Yi Ming Huang, Yi Chang Chou, Chen Yu Chao, Po Chen Tseng

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Aims: To report the effect of simultaneous intravitreal dexamethasone (DEX) and aflibercept for the treatment of diabetic macular edema (DME). Methods: This retrospective analysis of an open-label, multicenter, consecutive case series included 102 eyes of 81 patients with DME. Patients were selected into two groups. The control group consisted of 50 eyes treated with aflibercept alone, and the combination group consisted of 52 eyes treated with simultaneous DEX implant and aflibercept injection. The primary endpoints were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to month 6. The secondary endpoint was the interval of retreatment. Results: Baseline BCVA increased and CRT decreased at 6 months in both groups. Pseudophakic eyes in the combination group exhibited significantly greater BCVA improvement compared with phakic eyes (p = 0.031). Fewer intravitreal treatments were required for eyes treated with combination therapy than for those treated with aflibercept alone (1.56 ± 0.54 vs. 4.04 ± 1.26, p <.0001), with a mean retreatment interval of 3.66 ± 0.69 months. Conclusions: Simultaneous intravitreal DEX and aflibercept achieved non-inferior improvement of visual and anatomic outcomes compared with aflibercept alone for DME, but exhibited a significantly longer treatment interval and superior visual outcome in pseudophakic eyes. This therapeutic approach is considered a valid strategy for treating DME in the era of COVID-19.

Original languageEnglish
Pages (from-to)501-508
Number of pages8
JournalActa Diabetologica
Issue number4
Publication statusPublished - Apr 2022


  • Aflibercept
  • Combination therapy
  • Dexamethasone
  • Diabetic macular edema

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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