2Endocrinology and Internal Medicine, Prof. Dr. Cemil Tascioglu City Hospital, İstanbul, Türkiye DOI : 10.37845/ret.vit.2024.33.37 Purpose: We aimed to compare the anatomical and functional effects of aflibersept or ranibizumab in diabetic macular edema (DME) cases with non-responsiveness to bevasizumab.
Material and Methods: A retrospective study involving 95 eyes of 65 patients with DME previously treated with bevacizumab. Patients were switched either to ranibizumab or aflibercept. Detailed ophthalmological examination, best-corrected visual acuity (BCVA), and optical coherence tomography (OCT) (Spectralis; Heidelberg Engineering, Heidelberg, Germany) were performed on the first visit, pre-switch visit and final visit.
Results: Ninety five eyes of 65 patients were included in the study, of whom 40 patients (62 eyes) were switched to aflibercept and 25 patients (33 eyes) were switched to ranibizumab. Post-switch, there was a statistically significant improvement in the BCVA in both groups (aflibercept and ranibizumab). In addition, there was a statistically significant decrease in the central macular thickness (CMT) in both groups. There was no significant difference with regard to the change in macular thickness, OCT biomarkers or BCVA between the aflibercept and ranibizumab groups. In the subgroup analysis, the change in mean BCVA was significantly higher in the patients in the early switched group than the patients in the late switched group.
Conclusion: Significant anatomical and functional improvement was observed with ranibizumab and aflibercept treatments in DME patients who were non-responsive to bevasizumab. Early switching therapy may contribute to better visual outcomes than late switching therapy.
Keywords : Aflibersept, Ranibizumab, Diabetic Macular Edema, Early Switch, Late Switch