Diabetic Macular Edema in Maintenance: Intravitreal Scheduling

Objectives: To evaluate the effects of orally administered combination of Bromelain 250 mg from Ananas comosus (L.) Merr. Jambs and 250 mg Diosmin mcgSMIN Plus on visual acuity and central macular thickness (CMT) in patients treated for cystoid center-involving diabetic macular edema (DME) with anti-VEGF intravitreal maintenance therapy (IVT). Methods: Forty patients with type 2 diabetes and center-involving DME, treated with a maintenance protocol based on anti-VEGF, were enrolled in this prospective case-control study. Group A (20 eyes) received one pill containing bromelain (250 mg) and diosmin mcgSMIN Plus (250 mg) twice a day for two months. Group B (20 eyes) was monitored without drug administration until the next IVT. After two months and IVT administration, the groups were switched. At the end of the study, the collected data were divided into two groups. The treatment group included data from patients who received the dietary supplement, the control group consisted of data from patients who were only observed during anti-VEGF therapy. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) measurements were assessed at baseline, after two months, and after four months. Results: A statistically significant improvement in CMT was observed in the treatment group compared to the control group during follow-up (p < 0.05). However, the improvement in BCVA was not statistically significant. Conclusion: Orally administered combination of Bromelain 250 mg and 250 mg Diosmin mcgSMIN Plus has positive impact on central macular thickness in patients treated for cystoid center-involving diabetic macular edema (DME) with anti-VEGF intravitreal maintenance therapy.