Difference in Treatment Effect Between Intravitreal Aflibercept Injection and Laser by Baseline Factors in Diabetic Macular Edema

Purpose. To compare the visual and anatomic outcomes in patients with persistent diabetic macular edema (DME) who switched from ranibizumab to aflibercept with those who continued with previous ranibizumab therapy. Methods. In this retrospective comparative study, medical records of consecutive patients with center-involved DME ≥ 350 μm who had at least three recent consecutive monthly ranibizumab injections followed by as-needed therapy with either aflibercept or ranibizumab were reviewed. Data were collected at presentation (preinjection), at the intermediary visit, and at the last visit (at the end of the follow-up period). Results. Forty-three eyes of 43 patients were divided into two groups: the switch group (n=20) and the ranibizumab group (n=23). Though no significant improvement was found in the mean BCVA from the intermediary visit to the last visit, there was a difference in the mean CMT in the switch group and the ranibizumab group (p<0.001 and p=0.03, resp.). The mean CMT decreased after the intermediary visit by 188.6 ± 120.5 μm in the switch group and by 60.3 ± 117.1 μm in the ranibizumab group (p=0.003). Conclusions. Both aflibercept and ranibizumab decreased CMT in patients with persistent DME who showed a poor response to ranibizumab injections. However, switching to aflibercept provided only morphologic improvement.

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Aflibercept or ranibizumab for the treatment of diabetic macular edema; a retrospective study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1586 ◽

2019 ◽

Vol 10 (4) ◽

pp. 3000-3005

Author(s):

Khlood M. Aldossary ◽

Anfal Alruzuq ◽

Ghady Almohanna ◽

Hessa Almusallam ◽

Sara Alamri ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

P Value ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Injectable Drugs ◽

Significant Difference ◽

Intravitreal Aflibercept

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.

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EFFICACY AND SAFETY OUTCOMES OF INTRAVITREAL AFLIBERCEPT FOCUSING ON PATIENTS WITH DIABETIC MACULAR EDEMA FROM JAPAN

Retina ◽

10.1097/iae.0000000000002100 ◽

2019 ◽

Vol 39 (5) ◽

pp. 938-947

Author(s):

Hiroko Terasaki ◽

Kunihiko Shiraki ◽

Masahito Ohji ◽

Carola Metzig ◽

Thomas Schmelter ◽

...

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Efficacy And Safety ◽

Intravitreal Aflibercept ◽

Safety Outcomes

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Comparison of aflibercept and ranibizumab in diabetic macular edema associated with subretinal detachment

European Journal of Ophthalmology ◽

10.1177/1120672119827855 ◽

2019 ◽

Vol 30 (2) ◽

pp. 363-369 ◽

Cited By ~ 1

Author(s):

Abdullah Ozkaya ◽

Gokhan Demir ◽

Asli Kirmaci

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Secondary Outcome ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Intravitreal Aflibercept ◽

Best Corrected Visual Acuity

Purpose: To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment. Methods: This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness. Results: A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all). Conclusion: Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.

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