Back to Journals » Clinical Ophthalmology » Volume 15

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

Authors Pessoa B, Malheiro L, Carneiro I, Monteiro S, Coelho J, Coelho C, Figueira J, Meireles A, Melo Beirão JN

Received 5 September 2020

Accepted for publication 5 November 2020

Published 22 January 2021 Volume 2021:15 Pages 253—260

DOI https://doi.org/10.2147/OPTH.S280644

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Bernardete Pessoa,1,2 Luísa Malheiro,1 Inês Carneiro,1 Sílvia Monteiro,1 João Coelho,1 Constança Coelho,3 João Figueira,4– 6 Angelina Meireles,1,2 João Nuno Melo Beirão1,2

1Ophthalmology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal; 2Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; 3Genetics Laboratory, Institute of Environmental Health, Lisbon Medical School, University of Lisbon, Porto, Portugal; 4Centro Hospitalar e Universitário de Coimbra, Porto, Portugal; 5Faculty of Medicine of the University of Coimbra, Porto Portugal; 6Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal

Correspondence: Bernardete Pessoa
Centro Hospitalar e Universitário do Porto – Hospital de Santo António, Departamento de Oftalmologia, Largo Prof. Abel Salazar, Edifício Neoclássico, Porto 4099-001, Portugal
Tel +351 938469884
Email bbtpessoa@gmail.com

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.

Keywords: aflibercept, bevacizumab, diabetic macular edema, ranibizumab, refractory

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]