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Treatment with Ozurdex is associated with significant mean improvement in visual acuity. Clinicians should have a multimodality approach to treating DME and be aware of this treatment option in those who have a suboptimal response to anti-VEGF therapy. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:160-166.].

Purpose: To evaluate the relative diagnostic value of nonmydriatic fundus photography (nFP) among patients screened for diabetic retinopathy in remote rural medical clinics and an urban academic medical center for nonadherence to recommended annual dilated eye examination. Subjects and Methods: A retrospective cross-sectional study was performed among diabetic patients seen in primary outpatient clinics between 2006 and 2011 who were screened for diabetic retinopathy with nFP for history of nonadherence to recommended annual dilated eye examination. A single nonstereoscopic, 45°, 10-megapixel digital image of the disc and macula of both eyes was obtained locally and transmitted electronically to a retinal specialist for remote review. The results from remote rural Native American Indian reservations were compared with those from an urban academic family practice clinic. The proportion of subjects diagnosed with diabetic retinopathy and the quality of fundus images were compared. Results: Among 872 patients (1,744 eyes) screened from rural sites and 517 subjects (1,034 eyes) screened from an urban site, images were of good quality for evaluation in 82.4% and 85.7% of subjects, respectively. Diabetic retinopathy was noted in 12.6% of rural subjects and 29.6% of urban subjects (p < 0.001). Conclusions: nFP can be a useful tool in both rural and urban settings to screen for diabetic retinopathy in patients who are nonadherent to the recommended dilated annual eye exam. In our study population, a surprisingly higher percentage of diabetic subjects screened from the urban clinic had retinopathy compared with subjects screened in rural clinics.

Purpose To evaluate ocular hypertension (OHT) after Ozurdex injection to determine the incidence of OHT, therapy of OHT, and any associative factors such as diagnosis, underlying glaucoma and therapy, or sequential Ozurdex injection(s). Methods Retrospective consecutive case series with patients receiving one or more intravitreal Ozurdex implantations at a tertiary care academic center. OHT was defined as a single measurement of ≥30 mmHg, or an increase of ≥10 mmHg from baseline. Results Ninety-four injections in 52 patients (59 eyes) were reviewed. Forty eyes received a single injection, and 19 eyes received multiple injections. OHT developed in 14 patients (26.9%). Thirteen patients (25%) had pre-existing glaucoma or glaucoma suspicion, and six of these developed OHT. Glaucoma eye drops were initiated following 13 injections (13.8%). Invasive glaucoma surgery was required in three patients (3.2%): all had glaucoma or glaucoma suspicion (one case was related to neovascular glaucoma and unlikely related to steroid response after Ozurdex). There was no difference in relative IOP increase (i.e. difference between final follow-up or subsequent intravitreal injection versus baseline) between single versus multiple Ozurdex injections (P = 0.883). Conclusions 26.9% of patients who received Ozurdex developed OHT. Glaucoma or glaucoma suspicion factors were present in all patients who required invasive glaucoma surgery. A greater proportion of patients who received multiple injections had an IOP elevation, but the relative IOP increase was not significant.