Evaluation of Using Topical Bromfenac as an Adjunctive Treatment with Intravitreal Ranibizumab for Diabetic Macular Edema

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 centre involved diabetic macular edema (DME) with macular thickness (300-500um) 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 treatment of study group for six months from commencement of treatment. Efficacy of topical bromfenac was evaluated by comparing both groups through follow-up period as regards to visual acuity, central retinal thickness and the need of 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). 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 increase incidence of corneal side effects.