Macular Thickness Fluctuations in Eyes With Diabetic Macular Edema Treated With Intravitreal Steroid

Background and Objective: Macular thickness fluctuations (MTF) over time may be more predictive of visual outcomes than absolute macular thickness in patients with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (anti-VEGF). It is unclear whether this association exists in DME patients treated with intravitreal steroids or whether steroids confer reduced MTF versus anti-VEGF treatments. Patients and Methods: MTF was compared before and after initiation of steroids in DME patients treated with intravitreal steroids. A mixed-effects linear regression model was used to determine the association between MTF and best-corrected visual acuity (BCVA). Results: Mean 12-month MTF significantly decreased after steroid initiation (61.1 μm versus 53.5 μm, P = 0.04, n = 105 eyes). Mean BCVA after 12 months was not significantly different from baseline. No significant association between post-steroid MTF and 12-month BCVA was found. Conclusion: Steroid treatment decreases MTF while BCVA remains stable in DME patients previously treated with anti-VEGF. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:454–460.]