The Role of Dexamesthasone Intra-Vitreal Implant in Management of Various Causes of Macular Oedema

Abstract

SUMMARY M acular edema is a common cause of a sudden and/or chronic decrease in visual acuity occurring in many ophthalmic diseases as intraocular inflammation, central or branch retinal vein occlusion, diabetic retinopathy and most commonly following cataract extraction. The challenge concerning the management of macular edema arises in the chronic and persistent case, for which a stepwise therapeutic approach is optimal. The clinician must always be alert to the possible side effects of the many effective, but potentially toxic, pharmaceutical agents used to treat this entity. There are many options in treating macular edema including; Laser photocoagulation, Non-steroidal anti-inflammatory drugs, Carbonic anhydrase inhibitor, steroids, Intra vitreal injection of Anti vascular endothelial growth factor” Anti -VEGF” drugs and vitrectomy. Despite the success of agents targeted against vascular endothelial growth factor (VEGF) including ranibizumab, bevacizumab and aflibercept, significant unmet needs remain in the treatment of chronic DME, around a third or more of patients are considered insufficiently responsive to anti-VEGF therapy. Intravitreal steroids, particularly