Background and Objective: Optical coherence tomography (OCT) plays a crucial role in guiding the treatment and establishing the prognosis of diabetic macular edema (DME). We aimed to determine which OCT biomarkers respond better to intravitreal triamcinolone acetonide (IVTA) switch after antivascular endothelial growth factor (anti-VEGF) treatment poor response. Materials and Methods: Fifty-eight eyes with DME, submitted to IVTA switch, were included in this retrospective study. OCT biomarkers and best-corrected visual acuity (VA) were assessed, before and after treatment with a mean follow-up of 2.9 months. Results: IVTA switch resulted in improved VA, central foveal thickness (CFT), and macular volume. Intraretinal cysts decreased or disappeared completely (P = 0.007) in 84.2% of the eyes, as well as the hyperreflective foci (P = 0.004) and the subretinal fluid (P = 0.02). Conclusion: We show that IVTA switch is an effective rescue therapy in anti-VEGF therapy refractory DME. OCT plays an important role in selecting the most appropriate treatment, namely between anti-VEGF and steroids.

Roth spots can occur as ophthalmological manifestations of systemic pathologies that compromise the retinal capillary endothelium. A case report of retinopathy due to hemolytic anemia secondary to Epstein–Barr virus is presented. Given the clinical picture, several differential diagnoses were initially considered causing Roth spots that is why a brief review of the literature is carried out to raise awareness of the diverse pathologies that can be associated with the presence of Roth spots to provide timely referrals.