Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema

Nasser G Alsaedi,1,2 Ruba M Alselaimy,3 Abdulaziz A Alshamrani,1 Muhammed AlAjmi,4 Rajiv Khandekar,1 Hassan Al-Dhibi,1 Abdulelah A Al-Abdullah1 1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2King Abdullah Medical City, Makkah, Saudi Arabia; 3College of Medicine, King Saud University, R...

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Autores principales:	Alsaedi NG, Alselaimy RM, Alshamrani AA, AlAjmi M, Khandekar R, Al-Dhibi H, Al-Abdullah AA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	aflibercept bevacizumab persistent dme ranibizumab vegf switch vascular endothelial growth factor Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6c17e55774c24a50b1c2e43f1d1e0882
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spelling	oai:doaj.org-article:6c17e55774c24a50b1c2e43f1d1e08822021-12-02T18:31:00ZAflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema1177-5483https://doaj.org/article/6c17e55774c24a50b1c2e43f1d1e08822021-07-01T00:00:00Zhttps://www.dovepress.com/aflibercept-versus-ranibizumab-as-a-second-line-therapy-after-bevacizu-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Nasser G Alsaedi,1,2 Ruba M Alselaimy,3 Abdulaziz A Alshamrani,1 Muhammed AlAjmi,4 Rajiv Khandekar,1 Hassan Al-Dhibi,1 Abdulelah A Al-Abdullah1 1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2King Abdullah Medical City, Makkah, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Albahar Eye Centre, Kuwait City, KuwaitCorrespondence: Abdulelah A Al-AbdullahVitreoretinal and Uveitis consultant, Vitreoretinal division, King Khaled Eye Specialist Hospital, P. O. Box 7191, Riyadh, 11462, Saudi ArabiaTel +966114821234 extension 2655Email hasadoc@gmail.comPurpose: To compare the visual and anatomic outcomes of aflibercept versus ranibizumab as a second line treatment for persistent diabetic macular edema (DME) after initial bevacizumab injections.Methods: In this retrospective cohort study, patients with center-involved DME of ≥ 300 μm thickness after bevacizumab intravitreal injections in 2015– 2019 were included. Those treated with ranibizumab (R) and aflibercept (A) were grouped as group R and group A, respectively. The change in central macular thickness (CMT) measured by optical coherence tomography (OCT) and the best corrected distance visual acuity (BCVA) before and after three-monthly anti-VEGF injections (anti-VEGF) in group R and group A were compared and reviewed.Results: There were 80 eyes of 75 patients in group R and 80 eyes of 72 patients in group A. The initial bevacizumab injections in group R and group A varied significantly (p = 0.01). The median change of the CMT after the three injections was not significantly different in group R (80 μm) and group A (81.5μm) (p = 0.7). The improvement of BCVA in group R and group A was not significant (p = 0.5). Dry macula was noted in 1 vs 14 eyes in group R vs group A.Conclusion: After treating refractory DME with initial bevacizumab injections, 3 injections of either aflibercept or ranibizumab had similar anatomic and functional outcomes. Aflibercept achieved dry macula in more eyes with refractory DME compared to ranibizumab.Keywords: aflibercept, bevacizumab, persistent DME, ranibizumab, VEGF switch, vascular endothelial growth factorAlsaedi NGAlselaimy RMAlshamrani AAAlAjmi MKhandekar RAl-Dhibi HAl-Abdullah AADove Medical Pressarticleafliberceptbevacizumabpersistent dmeranibizumabvegf switchvascular endothelial growth factorOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2975-2980 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aflibercept bevacizumab persistent dme ranibizumab vegf switch vascular endothelial growth factor Ophthalmology RE1-994
spellingShingle	aflibercept bevacizumab persistent dme ranibizumab vegf switch vascular endothelial growth factor Ophthalmology RE1-994 Alsaedi NG Alselaimy RM Alshamrani AA AlAjmi M Khandekar R Al-Dhibi H Al-Abdullah AA Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
description	Nasser G Alsaedi,1,2 Ruba M Alselaimy,3 Abdulaziz A Alshamrani,1 Muhammed AlAjmi,4 Rajiv Khandekar,1 Hassan Al-Dhibi,1 Abdulelah A Al-Abdullah1 1King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 2King Abdullah Medical City, Makkah, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia; 4Albahar Eye Centre, Kuwait City, KuwaitCorrespondence: Abdulelah A Al-AbdullahVitreoretinal and Uveitis consultant, Vitreoretinal division, King Khaled Eye Specialist Hospital, P. O. Box 7191, Riyadh, 11462, Saudi ArabiaTel +966114821234 extension 2655Email hasadoc@gmail.comPurpose: To compare the visual and anatomic outcomes of aflibercept versus ranibizumab as a second line treatment for persistent diabetic macular edema (DME) after initial bevacizumab injections.Methods: In this retrospective cohort study, patients with center-involved DME of ≥ 300 μm thickness after bevacizumab intravitreal injections in 2015– 2019 were included. Those treated with ranibizumab (R) and aflibercept (A) were grouped as group R and group A, respectively. The change in central macular thickness (CMT) measured by optical coherence tomography (OCT) and the best corrected distance visual acuity (BCVA) before and after three-monthly anti-VEGF injections (anti-VEGF) in group R and group A were compared and reviewed.Results: There were 80 eyes of 75 patients in group R and 80 eyes of 72 patients in group A. The initial bevacizumab injections in group R and group A varied significantly (p = 0.01). The median change of the CMT after the three injections was not significantly different in group R (80 μm) and group A (81.5μm) (p = 0.7). The improvement of BCVA in group R and group A was not significant (p = 0.5). Dry macula was noted in 1 vs 14 eyes in group R vs group A.Conclusion: After treating refractory DME with initial bevacizumab injections, 3 injections of either aflibercept or ranibizumab had similar anatomic and functional outcomes. Aflibercept achieved dry macula in more eyes with refractory DME compared to ranibizumab.Keywords: aflibercept, bevacizumab, persistent DME, ranibizumab, VEGF switch, vascular endothelial growth factor
format	article
author	Alsaedi NG Alselaimy RM Alshamrani AA AlAjmi M Khandekar R Al-Dhibi H Al-Abdullah AA
author_facet	Alsaedi NG Alselaimy RM Alshamrani AA AlAjmi M Khandekar R Al-Dhibi H Al-Abdullah AA
author_sort	Alsaedi NG
title	Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
title_short	Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
title_full	Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
title_fullStr	Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
title_full_unstemmed	Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema
title_sort	aflibercept versus ranibizumab as a second line therapy after bevacizumab for diabetic macular edema
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/6c17e55774c24a50b1c2e43f1d1e0882
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Aflibercept versus Ranibizumab as a Second Line Therapy After Bevacizumab for Diabetic Macular Edema

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