An international team of researchers studied the efficacy of combined intravitreal injection of bevacizumab and intravitreal injection of the ROCK inhibitor fasudil and then compared it with IVB alone for patients with center-involved DME. While all of the 44 eyes randomized to one of two groups experienced improved best-corrected visual acuity (BCVA) at three months, only those with the combined therapy experienced improved BCVA up to month six.

The researchers noted 54.5% of the combination therapy eyes gained ≥15 ETDRS letters at month six compared with only 10% of the bevacizumab-only eyes. Between the benchmark evaluation and follow-up at three and six months, they recorded a significantly decreased mean BCVA of 5±7 ETDRS letters in the bevacizumab-only group but no significant deterioration in the combination therapy group.

“Adjunctive intravitreal injection of a rho-kinase inhibitor may enhance and prolong the therapeutic effects of anti-vascular endothelial growth factor drugs for center- involving DME,” the study concludes.

 Ahmadieh H, Nourinia R, Hafezi-Moghadam A, et al. Intravitreal injection of a Rho-kinase inhibitor (fasudil) combined with bevacizumab versus bevacizumab monotherapy for diabetic macular oedema: a pilot randomised clinical trial. Br J Ophthalmol. August 27, 2018. [Epub ahead of print].