Intravitreal dexamethasone for resistant wet-AMD

The advent of anti-vascular endothelial growth factor (anti-VEGF) intravitreal therapy introduced a new standard of care for patients with neovascular age-related macular degeneration (wet-AMD). Although anti-VEGFs are effective to prevent severe visual loss in most cases, often promoting a significant visual improvement, there are some patients with wet-AMD who continue to experience a visual deterioration despite an adequate treatment. Long-lasting intraretinal or subretinal fluid (IRF/SRF) may induce irreversible damage to retinal structures, preventing optimal visual recovery. Moreover, the need for frequent treatments for prolonged periods adds substantial burdens and safety concerns for these patients. Inflammation is involved in both the beginning and the progression of AMD. To counteract inflammation could lead to a better control of this pathology. The complementary action of intravitreal steroid injections in wet-AMD dates back to the combination of intravitreal triamcinolone acetonide (TA) with photodynamic therapy (PDT). The purpose of this study was to evaluate the anatomical and visual outcomes in patients with wet-AMD and persistent IRF/SRF, after adding dexamethasone intravitreal implant to the already on-going anti-VEGF therapy.