Topical bromfenac as adjunctive treatment with intravitreal ranibizumab for diabetic macular edema

Int Ophthalmol. 2023 Sep;43(9):3219-3226. doi: 10.1007/s10792-023-02722-1. Epub 2023 Apr 21.

Abstract

Purpose: To determine the safety and efficacy of adding topical bromfenac 0.09% in the treatment of diabetic macular edema.

Methods: Seventy patients (70 eyes) with center involved diabetic macular edema with macular thickness (300-500 μm) were included. Patients were divided randomly into two groups: 35 eyes in each group. Both groups were treated with intravitreal ranibizumab monthly for three consecutive months. Bromfenac 0.09% eye drops twice daily was added to the treatment of study group for six months from commencement of treatment. The efficacy of topical bromfenac was evaluated by comparing both groups through follow-up period as regards to visual acuity, central and average thickness and the need for re-injection.

Results: Patients treated with topical bromfenac in addition to intravitreal ranibizumab revealed significant improvement in visual acuity, more reduction in central and average macular thickness and less tendency to need reinjection compared to those treated with ranibizumab alone (p 0.013, p 0.010 and p 0.022, respectively). No side effects was encountered with the use of topical bromfenac.

Conclusion: Topical bromfenac 0.09% twice a day could enhance and sustain the efficacy of intravitreal ranibizumab in the treatment of diabetic macular edema without increasing the incidence of corneal side effects.

Keywords: Bromfenac; Diabetic macular edema; Intravitreal injection; Macular thickness; Ranibizumab.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Angiogenesis Inhibitors
  • Diabetes Mellitus*
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Ranibizumab / therapeutic use
  • Tomography, Optical Coherence
  • Treatment Outcome

Substances

  • Ranibizumab
  • bromfenac
  • Angiogenesis Inhibitors