Mohsen Abou Shousha, MD et al JMSCR Volume 03 Issue 10 October Page 7835 JMSCR Vol||3||Issue||10||Page 7835-7841||October 2015 Comparative Study of Intravitreal Ranibizumab with and Without Nepafenac Eye Drops for Center Involving Diabetic Macular Edema Authors Mohsen Abou Shousha MD, Hany Ahmed Helaly MD Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt Abstract Purpose: to compare intravitreal ranibizumab with and without Nepafenac eye drops as a treatment for center involving diabetic macular edema. Methods: This is a randomized, comparative, double masked, interventional prospective clinical study that included 60 eyes with center involving diabetic macular edema and had good metabolic control, randomly assigned into 2 groups (A and B). Patients had monthly intra-vitreal injection of 0.5 mg ranibizumab (Lucentis; Novartis, Basel, Switzerland and Genentech Inc., South San Francisco, CA) for the first three months. In the next nine months, reinjection was done according to predetermined reinjection criteria. Group B had in addition topical Nepafenac eye drops 0.1% (Nevanac; Alcon Labs, Fort Worth, TX, USA), three times daily for twelve months. Results: As regards the mean central macular thickness (CMT) at 12 months, it was 320 + 63 microns and 310 + 71 microns for group A and B respectively (p = 0.311). The mean number of injections in the 12 months follow up period was 6.9 + 1.1 (range from 5 to 9) and 5.9 + 1.18 (range from 4 to 8) for group A and group B respectively (p = 0.002). Conclusion: Nepafenac 0.1% eye drops three times daily may be a good adjuvant to intravitreal ranibizumab in the treatment of diabetic macular edema that decrease the number of ranibizumab injections needed for those patients. Keywords: Diabetic Macular Edema, Nepafenac, Ranibizumab, Lucentis; Intravitreal Injection. Introduction Diabetes Mellitus (DM) affects more than 220 million people worldwide. (1) Diabetic macular edema (DME) is one of the major causes of visual impairment in patients with diabetic retinopathy (DR). (2,3) With diabetes prevalence estimated to double during the next 20 years, (4) in the future it is likely that DME may be responsible for substantial vision loss unless treated adequately. The crude prevalence rate of DM in Egypt in 2008, was calculated to be 4.07%. (5) DR is the most common ocular complication of DM, (6) and its prevalence is higher in type I diabetics than in those with type II disease. (7) DR is the third most common cause of blindness in the United States and the leading cause of new blindness in individuals 20-74 years of age. (8) Macular edema is the major cause of visual loss in patients with DR. The incidence of DME after 10 years of follow-up has been reported to be higher in type II diabetes than in type I especially in insulin dependent type II diabetes. (9) www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x DOI: http://dx.doi.org/10.18535/jmscr/v3i10.21