simultaneous therapy with intravitreal dexamethasone implant and bevacizumab for the treatment of macular edema

to investigate the safety profile and benefits of a short-term simultaneous treat-ment combining two drugs: an intravitreal implant of dexamethasone with an intravitreal in-jection of bevacizumab in patients with macular edema, this study was performed. this was a retrospective, non-randomized, open-label case series study.  patients were treat-ed between april 2014 and july 2015 and were diagnosed with recurrent macular edema secondary to diabetic retinopathy and retinal vein occlusion. they underwent simultaneous treatment with an intravitreal injection of bevacizumab (1.25 mg) and an intravitreal implant of dexamethasone (0.7 mg). patients were evaluated at baseline and at each subsequent visit with a complete ophthalmological examination and spectral-domain optical coherence to-mography (oct) scans. they were examined 24 hours after the treatment, and then followed up after 30 days and 60 days. twenty patients (representing 20 eyes) were included in the study. at the time of injection (i.e., baseline), the best-corrected visual acuity (bcva) was 0.758 ± 0.42 logarithm of the minimum angle of resolution (logmar). it improved statistically significantly to 0.51 ± 0.33 logmar at 1 month and to 0.5 ± 0.34 logmar at 2 months (p ? 0.03). the median baseline central macular thickness (cmt) was 542 µm (interquartile range, 466–751 µm). the median cmt decreased statistically significantly to 321 µm (interquartile range, 288–381 µm) at 1 month, 310 µm (interquartile range, 286–354 µm) at 2 months (p ? 0.0002). the mean intraocular pressure (iop) increased from 14.9 ± 2.29 mmhg (at baseline) to 16.5 ± 2.99 mmhg (p = 0.04) after 2 months. two (10%) eyes had cataract progression. there were no other ocular or systemic complications for the duration of this study. in conclusions, simultaneous therapy combining a dexamethasone implant plus bevaci-zumab for macular edema may be an attractive treatment regimen with an acceptable safety profile.