How do you determine whether to switch to a different anti-VEGF agent or to Ozurdex after a patient with diabetic macular edema fails a series of Avastin?  

For my practice, macular oedema (CSME) is based on three factors. Ischemia, inflammation, and traction: the three factors which lead to persistent oedema. IVFA will show the level of non-perfusion in the far periphery, which is a major producer of VEGF, and laser (PRP) is the treatment. IV anti-VEGF...

The decision to switch to Ozurdex for treatment of diabetic macular edema depends largely on the OCT characteristics of the edema. If large cystic/cystoid-like edema is present centrally, then the more likely the patient will have a better or more dramatic anatomic response to intravitreal steroids,...