Diabetic Macular Swelling That Resists Injections: Early Results for a 6-Month Dissolving Steroid Implant

Diabetic macular edema (DME) is swelling in the center of the retina caused by leaky blood vessels in diabetes. Anti-VEGF injections are the usual first treatment, but many people respond only partly. For them, steroid implants placed inside the eye are an option, though current dissolving implants last about three months. In 2026, Eclipse Life Sciences announced early results for an implant designed to last about six months.

Why some eyes do not respond to injections

DME has more than one cause. In some eyes, the main driver is VEGF, the signal that injections block. In others, inflammation plays a bigger role, and those eyes often respond better to steroids. Data from the DRCR Retina Network suggest that people who respond poorly after three injections tend to remain poor responders, and specialists have noted that switching to steroids sometimes happens too late.

The BETTIS-1 trial

• About 75 patients with DME who had responded poorly to anti-VEGF injections, and whose eye pressure had not risen significantly with steroids before, were to be randomly assigned to a high or low dose of the new fluocinolone implant (EC-104) or to Ozurdex, the existing three-month dexamethasone implant.
• According to the company, both EC-104 doses met the main safety goal, with infrequent treatment-related side effects and no unexpected safety signals.
• The company reported better vision and retinal thickness results than Ozurdex at 24 weeks, with swelling reductions lasting through week 24.
• Eye pressure results were described as acceptable in this group selected because they tolerate steroids.

Important cautions

These are topline results announced by the company, without letter counts or detailed numbers yet. The trial was small, and patients were chosen because steroids had not raised their pressure before, so results may not apply to everyone. Steroids in the eye can raise pressure and speed cataract formation. A phase 3 trial would be needed before approval.

What this means for you

• If your vision is not improving after several injections, ask your retina specialist whether your swelling may be inflammation-driven and whether a steroid option makes sense.
• Keep pressure checks after any steroid treatment.
• Good blood sugar, blood pressure and cholesterol control supports any eye treatment.

Eyelid and orbit conditions can also affect people with diabetes; this oculoplastics education site explains them.

Our office refers diabetic macular edema care to retina specialists, and I encourage patients to ask about their options when progress stalls.

Source: EC-104 outperforms Ozurdex in phase 2 BETTIS-1 trial for anti-VEGF–resistant DME (Ophthalmology Times / Modern Retina, 2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.