Novel treatment regimen shows promise for diabetic macular edema
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For patients with diabetic macular edema (DME), intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection followed by a dexamethasone (DEX) intravitreal implant demonstrates noninferior efficacy and comparable safety to a conventional treatment regimen, according to a study published in the June issue of Eye Discovery.
Zhihui Dong, from The Third Affiliated Hospital of Wenzhou Medical University in Ruian City, China, and colleagues conducted a retrospective study to compare the efficacy and safety of a novel "1 + 1 + pro re nata" (PRN) regimen (one or two intravitreal anti-VEGF injections, followed by a DEX intravitreal implant, and subsequent management with anti-VEGF therapy on a PRN basis; 10 patients [12 eyes]) to the conventional "3 + PRN" regimen (three consecutive monthly intravitreal anti-VEGF injections followed by PRN treatment; 13 patients [16 eyes]) for treatment of DME over 25 weeks.
The researchers observed significant improvements from baseline in best-corrected visual acuity, central macular thickness (CMT), hyperreflective foci, and cyst area within the deep capillary plexus in association with both regimens. A numerically greater visual benefit was seen with the "1 + 1 + PRN," but this finding did not reach statistical significance. Over time, there was a steady decrease in CMT in the "1 + 1 + PRN" group, without notable fluctuation, while mild fluctuations were seen in the "3 + PRN" group during follow-up. The "1 + 1 + PRN" group had a significantly lower total number of intravitreal injections. No significant difference was seen between the groups in the incidence of elevated intraocular pressure.
The "1 + 1 + PRN" regimen "showed potential advantages in visual benefit and therapeutic stability, while also reducing the overall injection burden," the authors write.
More information
Zhihui Dong et al, A short-term observational study: initial intravitreal anti-VEGF injection followed by dexamethasone intravitreal implant for diabetic macular edema, Eye Discovery (2026). DOI: 10.1016/j.edisc.2026.100037
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