Methods: Twenty-seven eyes of 27 patients who received a single dose of an intravitreal dexamethasone implant (group 1) and 32 eyes of 32 patients who received three doses of an intravitreal afl ibercept injection (group 2) were included in the study. All the patients had DMO, accompanied by serous retinal detachment (SRD) and hyperrefl ective dots (HRDs), with an insuffi cient response to three doses of bevacizumab. The effi cacy of the intravitreal dexamethasone implant and afl ibercept injection was assessed 1, 2 and 3 mo later by analysing changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT).

Results: The mean age of the patients in group 1 and 2 was 62.22 ± 7.49 and 63.06 ± 8.20 years. Although there was no signifi cant difference in the BCVA between groups at the 1- and 3-mo follow-ups, there was a statistically signifi cant increase in the BCVA in group 1 at the 2-mo follow-up. There was a statistically signifi cant decrease in CMT at the 2- and 3-mo follow-ups in group 1 as compared to that in group 2.

Conclusions: In patients with DMO accompanied by an infl ammatory phenotype and insuffi cient response to bevacizumab, dexamethasone implant was more effective in terms of both visual and anatomical results compared to afl ibercept in a 3-mo follow-up study In refractory cases, switching to appropriate treatment before photodegeneration occurs affects visual results. Keywords : Afl ibercept, Dexamethasone, Hyperrefl ective dot, Infl ammatory phenotype, Serous detachment