UNREPORTED SIDE EFFECT OF INTRAVITREAL DICLOFENAC IN CHRONIC DIABETIC MACULAR EDEMA

To evaluate the safety and efficacy of intravitreal diclofenac sodium.

A 61-year-old male with persistent diabetic macular edema was treated with 450 μg of intravitreal diclofenac sodium (systemic preparation).

Postinjection Day 1, the spectral domain optical coherence tomography showed irregular vitreoretinal interface with wrinkling and separation of the internal limiting membrane from the nerve fiber layer with homogeneity of the inner layers. At 1 month, the compactness of the retinal layers was restored. Complete resolution of the cystoid macular edema was seen. At 1 year, there was mild flattening of the foveal depression with epiretinal membrane.

Various studies have shown the safety and efficacy of intravitreal diclofenac without any reported side effect. We report the inner retinal toxicity in the form of cystic spaces and splitting of internal limiting membrane from nerve fiber layer on the first follow-up day, postinjection, which resolved over a period of 1 month. Further studies are needed to assess the safety of intravitreal diclofenac sodium.