Based on the Real-Life Data of Türkiye; Comparison of Anatomical and Functional Outcomes of Phakic and Pseudophakic Patients in Wet Type Age-Related Macular Degeneration.

Objectives: The aim of the study was comparison of wet-type age-related macular degeneration in phakic and pseudophakic patients in terms of anatomical and functional success based on the real-life data of Türkiye. Methods: The multicenter retrospective real-life study data of the. retinal study group were used in this study. Among 867 eyes of 867 patients were included in the study. Patients were divided into two groups according to the status of the lens; phakic group and pseudophakic group. The follow-up period of the two groups, the number of injections at the 1st, 2nd, and 3rd years, and changes in the central macular thickness (CMT, µ) and visual acuity (VA, logMAR) of the patients at the beginning, 6th, 12th, 24th, and 36th months were examined. Results: In our study, the number of injections in the 1st, 2nd, and 3rd years, respectively, was 4.2±2.0, 1.8±1.9, and 1.0±1.7 in the phakic group, and 3.9±2.0, 1.7±1.9, and 0.8±1.4 in the pseudophakic group. When the two groups were compared in terms of the number of injections, there was a statistically significant difference in the 1st year, but there was no significant difference in the 2nd and 3rd years (p=0.001, p=0.350, and p=0.288, respectively). There was no statistically significant difference between the groups in terms of CMT in the baseline, 6th, 12th, 24th, and 36th months (p=0.991, p=0.327, p=0.652, p=0.599, and p=0.873, respectively). Although there was no difference in VA between groups at the beginning (p=0.052), the phakic group showed statistically better VA in controls at 3rd, 6th, 12th, 24th, and 36th months (p=0.001, p=0.001, p=0.000, p=0.000, and p=0.003, respectively). Conclusion: Differences in the number of injections and visual results between phakic and pseudophakic patients in wet type AMD may necessitate the creation of different treatment and follow-up protocols.

Results of anti-VEGF treatment for neovascular AMD in eyes with different baseline visual acuity in Turkish population-based on real life data-Bosphorus retina study group.

BACKGROUND: To investigate the anatomical and visual outcomes of the patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (anti-VEGF), according to the baseline best-corrected visual acuity (BCVA) based on the multicenter real-life data. METHODS: Five-hundred-ninety patients who had taken the Pro Re Nata (PRN) treatment regimen with three loading doses and at least one year of follow-up were included. The patients were divided into three groups according to the baseline BCVA: Group 1 (BCVA ≥ 1.3 Logmar), Group 2 (1.3 Logmar > BCVA ≥ 0.3 Logmar), and Group 3 (BCVA ≤ 0.2 Logmar). BCVA, central macular thickness (CMT), and the number of injections and visits were evaluated. RESULTS: There were 175, 322, and 93 patients in Group 1, Group 2, and Group 3, respectively. The number of visits and injections in the 1st year was not different between the groups (p = 0.58 and p = 0.08) and was 7.09 and 4.41 (Group 1), 6.59 and 5.58 (Group 2), 6.77 and 4.08 (Group 3). There was a significant difference in CMT between the baseline and 12th month in Group 1 and Group 2 (p < 0.001, p < 0.001, respectively) but not in Group 3 (p = 0.84). BCVA was significantly better in the 12th month in Group 1 (p < 0.001), slightly worse in Group 2 (p = 0.79), and significantly worse in Group 3 (p < 0.001). CONCLUSION: This study provides evidence that an inadequate number of injections cannot protect vision. Moreover, it can cause vision loss, especially in the eyes with good vision.

Comparison of Intravitreal Dexamethasone Implant and Intravitreal Ranibizumab Efficacy in Younger Patients with Branch Retinal Vein Occlusion.

Objectives: This study aimed to compare the effects of dexamethasone (DEX) implants and ranibizumab (RAN) injections in younger patients with macular edema due to branch retinal vein occlusion (RVO) in a 6-month follow-up. Methods: The treatment-naive patients with macular edema secondary to branch RVO were included retrospectively. Medical records of patients who were treated with intravitreal RAN or DEX implant were evaluated before and at the 1st, 3rd, and 6th months after the injection. Primary outcome measures were the change in best-corrected visual acuity (BCVA) and central retinal thickness. The level of statistical significance was set at 0.05/3=0.016, according to the Bonferroni correction. Results: Thirty-nine eyes of 39 patients were included in the study. The mean age of the study population was 53.82±5.08 years. Median BCVA in the DEX group (n=23) at baseline, 1st, 3rd, and 6th month was 1.1, 0.80 (p=0.002), 0.70 (p=0.003), and 1 (p=0.018) logarithm of the minimum angle of resolution (log-MAR), respectively (p<0.05). Median BCVA in the RAN group (n=16) at baseline, 1st, 3rd, and 6th months was 0.90, 0.61, 0.52, and 0.46 logMAR, respectively (p<0.016 for all comparisons). Median central macular thickness (CMT) in the DEX group at baseline, 1st, 3rd, and 6th months was 515, 260, 248, and 367 µm, respectively (p<0.016 for all comparisons). Median CMT in the RAN group at baseline, 1st, 3rd, and 6th months was 432.5 (p<0.016), 275 (p<0.016), 246 (p<0.016), and 338 (p=0.148) µm. Conclusion: There is no significant difference in treatment efficacies in both visual and anatomical outcomes at the end of the 6th month. However, RAN can be considered the first choice in younger patients with macular edema secondary to branch RVO because of the lower side effect profile.

Can optical coherence tomography findings be related with suicide attempt in bipolar disorder?

BACKGROUND: The aim was to investigate the relationship between OCT findings and suicidal behavior (SB) in patients with Bipolar Disorder type 1 (BPD1) in comparison to healthy controls. METHODS: Forty five euthymic BPD1 patients with previous suicide attempts (BPD1+), 46 euthymic BPD1 patients without previous suicide attempts (BPD1-) and 63 healthy controls were included. The subjects were evaluated with Sociodemographic Data Form, SCID, Suicide Behaviors Questionnaire, Beck Depression Inventory, Young Mania Rating Scale and OCT. RESULTS: All OCT measures were lower in patients with BPD1 than healthy controls (p<0.001). While no significant differences were found between (BPD1+) and (BPD1-) in all GCC levels and inferior RNFL values (p>0.05), the superior RNFL and global RNFL values were found to be lower in the (BPD1+) than in the (BPD1-) (p = 0.037, p = 0.028, respectively). Global RNFL was found to significantly predict suicide risk in a multivariate logistic regression model (p = 0.024 Exp(B):0.930). CONCLUSIONS: Neurodegeneration might occur during the course of BPD1 and SB. Decreased RNFL may be important for neurodegeneration related to SB.

Shaken baby syndrome in an infant treated for retinopathy of prematurity with anti-VEGF injection.

We present the case of an infant who received bevacizumab treatment for retinopathy of prematurity (ROP) and developed retinal hemorrhages 12 weeks later. Although preretinal hemorrhages along the ROP's ridge were a concern for recurrence, we decided to investigate other etiologies because of numerous retinal hemorrhages in different retinal layers and their concentration in the posterior pole. Cranial magnetic resonance imaging revealed a new-onset subdural hemorrhage. Factors that were suspicious for trauma were identified in the detailed history taken from the family by the hospital's child abuse team. This case highlights the importance of considering the characteristics of retinal hemorrhages in infants with ROP and conducting any necessary investigation.

Ocular pulse amplitude and visual field changes in patients diagnosed with aortic regurgitation.

PURPOSE: To examine whether there is a relationship between ocular pulse amplitude (OPA), intraocular pressure (IOP), and visual field (VF) deterioration among the patients diagnosed with aortic regurgitation (AR). METHODS: Twenty-nine patients (average age of 62.06 ± 13.27 years) with AR diagnosis without glaucoma history as AR group and 32 healthy participants (average age 63.81 ± 6.42 years) as control group were included in the study. Routine ophthalmologic examination including VF test [mean deviation (MD), pattern standard deviation (PSD) and VF index (VFI) values were recorded], diurnal IOP and OPA measurements with Pascal dynamic contour tonometry (DCT) was conducted on the patients. VF deficits were classified by Glaucoma Staging System 2 (GSS 2) score. RESULTS: Sixteen (50.0%) of 32 healthy subjects and 14 (48.3%) of 29 AR patients were female (p = 1.000). The measurement conducted at 15:30 among the diurnal IOP measurements performed with the Pascal DCT was found to be statistically significantly higher in the AR group (p = 0.009). While the MD and PSD values of the group diagnosed with AR were determined to be statistically significantly high, the VFI value was found to be significantly low. When the healthy cases and the patients diagnosed with AR were compared, it was observed that there was a statistically significant positive correlation in terms of the significant GSS 2 stage (p < 0.001). CONCLUSION: Although there was no significant increase in IOP, VF deficits were detected in patients with AR. These VF pathologies may be due to the ocular perfusion disorder in AR. However, additional comprehensive studies that also examine perfusion are needed to further confirm this.

Assessment of the choroidal thickness, central macular vascular and optic disk perfusion in migraine patients with optical coherence tomography angiography.

BACKGROUND: Comparing the central choroidal thickness (CCT) and the perfusion of the macula and optic disk in patients with migraine and control group participants using optical coherence tomography angiography (OCTA). METHODS: A total of 38 patients diagnosed with migraine and 32 healthy controls were recruited. OCTA scans were performed on all participants. Optic disk, central macular vascular perfusions, and CCT were measured. RESULTS: Thirty-eight eyes of 38 participants (34 female and 4 male) in the migraine group and 32 eyes of 32 participants (19 female and 13 male) in the healthy control (HC) group were evaluated. The mean age was 42.74 ± 8.14 and 43.09 ± 14.28 years in the migraine group and HC group, respectively. The mean CCT were 314 ± 103 µm and 301 ± 71 µm in the migraine and HC group, respectively (p = 0.54). The mean optic disk perfusions were 44.77 ± 1.93% and 45.25 ± 1.43% in migraine and HC group, respectively (p = 0.25). The mean central macular vascular perfusions were 20.50 ± 8.20% and 18.65 ± 7.46% in migraine and HC group, respectively (p = 0.32). There was a significant negative correlation between CCT and the duration of migraine history (p = 0.004). CONCLUSIONS: The macular and peripapillary microvasculature were not significantly different in patients with migraine than in HC. As the duration of migraine prolonged, a significant decrease in choroidal thickness was observed.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive.

PURPOSE: To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. METHODS: Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. RESULTS: The median age of patients was 64 (range, 46-82) years, and the median duration of symptoms was 15 (range, 7-60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the following 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. CONCLUSIONS: Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

Comparison of Adult Refractive Disorder Measurements Using HandyRef-K, Retinomax, Plusoptix, and Table-top Autorefractometer Devices.

OBJECTIVES: This study was conducted to compare refractive error measurements recorded using the Nidek HandyRef-K handheld autorefractometer (HDY; Nidek Co. Ltd., Tokyo, Japan), Plusoptix A09 photorefractor (PO; Plusoptix GmbH, Nuremberg, Germany), Retinomax K-plus 3 (RTX; Right Mfg. Co. Ltd., Tokyo, Japan), and a table-mounted autorefractometer/keratometer (TTR; URK 800, Unicos Co. Ltd., Daejeon, Republic of Korea). METHODS: Patients aged ≥18 years underwent measurement of refraction without cycloplegia using 4 devices and the spherical power (SP), cylindrical power (CP), and spherical equivalent (SE) values were analyzed and compared. RESULTS: A total of 181 eyes of 181 patients were enrolled in the study. The mean age of the patients was 33.08±0.95 years (range: 18-79 years). There was a significantly significant difference in the SP, CP, and SE values determined by the devices (p<0.001). The SP and SE values of the RTX and the HDY were similar, while the other device results were different (Wilcoxon signed-rank test, p=0.004). The CP values of the PO and the TTR, the HDY and the TTR were also comparable. CONCLUSION: The HDY, RTX, and the PO are suitable for screening in clinical practice, but the findings strongly suggest that they should be used with caution.

The Treatment Models for Adenoviral Keratoconjunctivitis in the Childhood Population.

Purpose: To examine the effects of treatments performed on children with adenoviral conjunctivitis.Methods: 50 children with Adenoviral keratoconjunctivitis (AK) were evaluated. Patients were divided into four groups according to the medical treatment agents that were used previously. AK symptoms were clinically scored and analyzed. The diagnosis of all children was confirmed by an in-office lateral flow immunoassay.Results: Fifty patients with AK were included in the study. 24 (48%) were female and 26 (52%) were male. The mean age was 12.88 ± 2.66 (8-17). In PVP-I groups clinical findings shows faster improvement than other groups (p < .05).Conclusions: Conjunctival irrigation with 2.5% PVP-I is very effective for the treatment of adenoviral conjunctivitis in childhood. Ganciclovir ophthalmic gel 0.15% increases the effect of 2.5% PVP-I on AK, but this was not statistically significant.

Comparison of success between external and endonasal dacryocystorhinostomy in primary acquired nasolacrimal duct obstruction in Turkish cohort.

OBJECTIVE: To evaluate the results and recurrence rates of external and endonasal dacryocystorhinostomy (DCR) surgery in patients with primary acquired nasolacrimal duct obstruction (PANDO) in Turkish Cohort. METHODS: Medical records were reviewed in all patients who underwent surgery for PANDO between January 2010 and September 2014 in a tertiary university hospital retrospectively. The patients were followed up on the first day, first month, third month and sixth month postoperatively. Lacrimal drainage system and recurrence rates were recorded. RESULTS: This study was conducted in 81 patients, 27 of whom were men (33.3%) and 54 were women (66.7%). The mean follow-up time was 30.13±16.42 months (range 6-62 months). The mean age was 50.51±12.47 years (range 16 to 77 years). External DCR was used in 44 (66.7%) of the cases and endonasal DCR was used in 37 (45.7%) of the cases. Surgical results of DCR were divided into three groups based on the integrity and openness of the lacrimal drainage pathway in all PANDO patients. Operation success rates of these data revealed that 45 (55.6%) cases were recorded as successful, 20 (24.7%) of the cases were accepted as partially successful and 16 (19.8%) of the cases were deemed as unsuccessful. Based on these data, surgical success rates were found in 38 (86.4%) patients in external DCR and 27 (73%) patients in endonasal DCR. Surgical failure rates were six (13.6%) in external DCR and 10 (27%) in endonasal DCR. There was no statistically significant difference between success rates and recurrences in both groups (p>0.05). CONCLUSION: Endoscopic DCR produced simple, minimally invasive and preferable results compared to external DCR in the Turkish population. Although the success of external DCR is higher and the recurrence is lower than endoscopic DCR, with the outcomes of this study, endoscopic DCR can be tried as the first choice to protect the patient from major surgery and anesthesia in PANDO.

Secondary epiretinal membrane following rhegmatogenous retinal detachment.

PURPOSE: To investigate the outcomes of removal of the secondary epiretinal membrane (ERM) after rhegmatogenous retinal detachment (RRD) repair. MATERIALS AND METHODS: Retrospective cese series study. Eighteen consecutive patients (18 eyes) who underwent secondary ERM removal after successful RRD repair were reviewed. The postoperative visual outcomes, intraoperative and postoperative complications and the images of spectral-domain optical coherence tomography (SD-OCT) were analyzed. RESULTS: The mean VA improved from 20/117(logMAR 0.76) preoperatively to 20/81(logMAR 0.60) postoperatively (p = 0.086). The preoperative central foveal thickness of 384.3µm ± 137 decreased to 243.6µm ± 89 postoperatively (p < 0.001). CONCLUSIONS: In our series, performing operation to secondary ERM after retinal detachment surgery had clinical and anatomical success.

Comparison of two different treatment regimens' efficacy in neovascular age-related macular degeneration in Turkish population-based on real life data-Bosphorus RWE Study Group.

AIM: To compare two different anti-vascular endothelial growth factor (anti-VEGF) treatment regimens'-a priori pro re nata (PRN) and PRN regimen following the loading phase-anatomical and functional results in neovascular age-related macular degeneration (nAMD) patients. METHODS: Totally 544 nAMD patients followed and treated with aflibercept (n=135) and ranibizumab (n=409) at 9 different centers between 2013 and 2015 were enrolled into this retrospective multicenter study. Patients with initial best corrected visual acuity (BCVA) interval of 1.3-0.3 (logMAR) and a minimum follow-up of 12mo were included. Patients under two different regimens-a priori pro re nata (1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen (3+PRN)-were compared in BCVA at 3th, 6th and 12th months, and in central macular thickness (CMT) at 6th and 12th months. The total study group, intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in the 1+PRN (n=101) regimen from 407 to 358 and 340 µm and in the 3+PRN (n=443) group from 398 to 318 and finally to 310 µm at months 6 and 12, respectively. Anatomically, the CMT reduction at 6th month (48.5 vs 76.4; P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75; in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3th month (-0.01 vs 0.12; P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6th (44 vs 72) and 12th month (61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3th month (-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction (61 vs 89, 6th month; 85 vs 97, 12th month) and visual gain (0.02 vs 0.16; 0.02 vs 0.14; 0.05 vs 0.11) was found in favor of 3+PRN group at all visits. CONCLUSION: The loading dose of anti-VEGF treatments in nAMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.

The effect of the smoking on choroidal thickness, central macular vascular and optic disc perfusion.

OBJECTIVES: To compare choroidal thickness, central macular vascular perfusion and optic disc perfusion in smokers and non-smokers. METHODS: Smoker participants defined group I and non-smoker participants(group II) Optical coherence tomography angiography (OCTA) performed to all volunteers and choroidal thickness, central macular vascular and optic disc perfusion were measured. RESULTS: In group I, 30 eyes of the 30 participants (6 male and 24 female) evaluated and in group II, 32 eyes of the 32 participants (13 male and 19 female) evaluated. The mean age of the volunteers were 43.09 ±â€¯14.28 and 42.2 ±â€¯8.24 year-old in group I and group II, respectively. The mean choroidal thickness were 345 ±â€¯74 µm and 301.6 ±â€¯71 µm in group I and group II, respectively (p = 0.022). The mean optic disc perfusions were 45.17 ±â€¯1.46% and 45.25 ±â€¯1.43% in group I and group II, respectively (p = 0.82). The mean central macular vascular perfusions were 20.20 ±â€¯7.17% and 18.65 ±â€¯7.46% in group I and group II, respectively (p = 0.4). There are a negative correlation between macular vascular perfusion, optic disc perfusion and smoking period (p = 0.32 and 0.62, respectively.) CONCLUSION: Our study revealed that smoking statistically significantly effected choroidal thickness but effected central macular vascular and optic disc perfusion changes were not statistically significant.

The Role of Bacterial Etiology in the Tear Duct Infections Secondary to Congenital Nasolacrimal Duct Obstructions.

PURPOSE: To define the microbiological features of dacryocystitis in childhood. METHODS: Patients with dacryocystitis secondary to CNLDO between 2017 and 2019 in Izmir, Turkey were included in the study. Inclusion criteria of the study were: mucopurulent secretion, being under 4 years old and not having received prior antibiotic treatment. Samples from secretion were cultivated in sheep blood agar, eosin methylene blue, and chocolate agar. Reproduction was checked intermittently. Clinically significant growths were reported. RESULTS: Seventy patients with dacryocystitis secondary to CNLDO were included in the study. Sixty percent of patients were female (n = 42) and 40% (n = 28) percent of patients were male. The average age of participants was 2.09 ±â€Š0.68 (1-3) years old. Positive bacterial proliferation results were noted in 20 patients (28.6%). Eighty percent (n = 16) of culture-positive bacterias were gram-negative bacterias and 20% (4) were gram-positive bacterias. Twenty percent of culture-positive bacterias were aerobic and 80% were facultative bacterias. The most common bacteria seen in culture specimen was Haemophilus 40% (Haemophilus haemolyticus [20%] and Haemophilus influenzae [20%]). CONCLUSIONS: Gram-negative organisms especially Haemophilus were most prevalent. These findings could be helpful for antibiotic selection.

Association between choroidal vascular density, age and sex: A prospective study.

OBJECTIVE: To evaluate choroidal vascular density changes in regards to age and sex. METHODS: This was a prospective, cross-sectional study. We studied 78 volunteers. All participants underwent a complete ophthalmologic examination and assessment of the choroidal vascular density (CVD) using swept-source optical coherence tomography (SS-OCT). CVD obtained by automated software of the SS-OCT. We evaluated the CVD correlation with age and compared female to male. RESULTS: The study included 78 right eyes of 78 individuals: 40 females and 38 males. The participants' age and the CVD were significantly correlated (r= -0.39, p < 0.001). The mean CVD of the females and males were 0.26 ±â€¯0.08 and 0.23 ±â€¯0.05, respectively (p = 0.03). CONCLUSION: CVD was found to be associated with age and sex.

Aggressive Posterior Retinopathy of Prematurity Treated with Intravitreal Bevacizumab: Late Period Fluorescein Angiographic Findings.

OBJECTIVE: To evaluate vascularization end limit of the peripheral retina and describe vascular development patterns of patients at the late period with aggressive posterior retinopathy of prematurity (APROP) who were treated with a single intravitreal injection of bevacizumab. METHODS: All patients were examined with RetCam III and fluorescein angiography (FA) within 90-100 gestational week. The vascularization end limit according to the zones and vascular structural abnormalities were noted. RESULTS: A total of 116 eyes of 58 patients were included. The mean gestational age and birth weight were 28.31 ± 2.5 (23-33) weeks and 1156.29 ± 386.38 (360-2300) g, respectively. The mean age at the time of FA was 95.09 ± 3.8 (90-100) weeks. According to the vascular termini, four eyes (3.4%) were in zone II posterior, 30 eyes (25.8%) were in zone II anterior, 22 eyes (18.9%) were in zone III with a distance of > 2 disc diameter (DD) from ora serrata, and 60 eyes (51.7%) were in zone III with a distance of < 2 DD from temporal ora serrata. Abnormal vascular findings were detected in 86.2% of patients (100/116 eyes) including circumferential vessels (43.1%), abnormal vascular branching (25.9%), closely packed vascular shunts (6.8%), and vascular leakage (10.3%). CONCLUSION: FA gives us quantitative data for treatment decision at late period of APROP patients treated with bevacizumab. Fluorescein leakage and persistent avascular areas still detected at FA at 90-100 gestational weeks increase the risk for late complications. FA can detect the abnormalities that can not be detected via indirect ophthalmoscope and be useful for follow-up and further treatments of APROP.

Evaluation of the effect of combined intravitreal ranibizumab injection and sub-tenon steroid injection in the treatment of resistant diabetic macular edema.

PURPOSE: To compare sub-tenon steroid plus anti-VEGF injection with anti-VEGF injection solely in the treatment of resistant diabetic macular edema (DME). METHOD: Patients who exhibited insufficient anatomic [over 350 µm central macular thickness (CMT)] and less than 3 lines of visual gain at least six anti-VEGF injections, were randomly divided into two groups. In group I, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [Triamcinolone acetonide (Sinakort-A®)]. And anti-VEGF was performed when needed during the follow-up period. In group II, treatment was continued with anti-VEGF only. All patients' visual acuity and CMT were followed up for 6 months. RESULTS: The baseline BCVA in group I and group II was 0.51 ± 0.667 logMAR and 0.47 ± 0.60 logMAR, respectively (p = 0.52). In group I and II, at the end of 6-month follow-up, BCVA improved to 0.38 ± 0.60 logMAR (p < 0.001) and 0.43 ± 0.60 logMAR (p = 0.20), respectively. The baseline CMT in group I and group II was 494 ± 118.32 and 438.20 ± 90.99 µm, respectively (p = 0.029). In group I and II, at the end of 6 months, CMT decreased to 302.57 ± 69.89 µm (p < 0.001) and 439.20 ± 107.6 µm (p = 0.96), respectively. CONCLUSION: Adding steroid to routine anti-VEGF treatment is an effective way of treatment method for resistant DME.