Intravitreal dexamethasone implant in epiretinal membrane-associated diabetic macular edema refractory to anti-VEGF therapy: a visual performance and retinal ultra-structural analysis.

OBJECTIVE: The aim of the study was to report clinical outcomes of intravitreal dexamethasone (DEX) implant in patients with epiretinal membrane (ERM)-associated diabetic macular edema (DME) unresponsive to intravitreal ranibizumab (IVR). MATERIALS AND METHODS: 11 eyes of type 2 diabetes patients >18 years old with ERM-associated DME unresponsive to ≥3 IVR injections were included. Patients with central macular thickness (CMT) >300 µm following a single dose DEX implant between January 2021 and December 2023, suggesting unresponsiveness or poor response, were retrospectively evaluated. A full ophthalmologic examination was performed pre- and first-to-sixth month post-therapy, including measuring best-corrected visual acuity (BCVA), intraocular pressure (IOP), and retinal ultra-structural parameters like CMT, central 1 mm retinal thickness (RT), and central macular volume (CMV). RESULTS: The mean age was 66.50±5.01 years. BCVA increased considerably in the first two months (p