Intravitreal Ranibizumab or Aflibercept After Bevacizumab in Diabetic Macular Edema: Exploratory Retrospective Analysis

Aim: To evaluate the efficacy of switching from bevacizumab to ranibizumab or aflibercept in eyes with diabetic macular edema (DME) unresponsive to bevacizumab. Methods: Single-center retrospective comparative study of patients with DME unresponsive to intravitreal bevacizumab that was switched to r...

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Bibliographic Details
Main Author: Pessoa, Bernardete (author)
Other Authors: Malheiro, Luísa (author), Carneiro, Inês (author), Monteiro, Sílvia (author), Coelho, João (author), Coelho, Constança (author), Figueira, João (author), Meireles, Angelina (author), Beirão, João Nuno Melo (author)
Format: article
Language:eng
Published: 2021
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Online Access:http://hdl.handle.net/10316/103835
Country:Portugal
Oai:oai:estudogeral.sib.uc.pt:10316/103835
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Summary:Aim: To evaluate the efficacy of switching from bevacizumab to ranibizumab or aflibercept in eyes with diabetic macular edema (DME) unresponsive to bevacizumab. Methods: Single-center retrospective comparative study of patients with DME unresponsive to intravitreal bevacizumab that was switched to ranibizumab or aflibercept. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were analysed prior to and 4 months after the switch. Ocular coherence tomography (OCT) biomarkers were also analysed. Results: Fifty-six eyes from 40 patients were included in the study, 33 eyes switched to ranibizumab and 23 to aflibercept. A significant median CFT decrease was observed in both groups (p<0.001), with no between-group differences. BCVA gain was only significant in the ranibizumab group (p<0.001). None of the pre-baseline or baseline parameters were associated with the response to ranibizumab or aflibercept. Conclusion: In persistent DME unresponsive to bevacizumab, both anatomical and functional improvements were observed with ranibizumab whereas aflibercept only showed an anatomical improvement. Clinicaltrials.gov NCT04018833.