Korean J Ophthalmol.  2019 Apr;33(2):122-130. 10.3341/kjo.2018.0037.

Switching to Aflibercept in Diabetic Macular Edema after Unsatisfactory Response to Other Anti-vascular Endothelial Growth Factor Drugs

• Ibrahim WS
• Eldaly ZH
• Saleh MG
• Rateb MF
• Aldoghaimy AH

• KMID: 2442616
• DOI: http://doi.org/10.3341/kjo.2018.0037

Abstract

PURPOSE
To evaluate the efficacy of switching to aflibercept in diabetic macular edema (DME) with suboptimal response to previous anti-vascular endothelial growth factor (anti-VEGF) injections.
METHODS
A prospective interventional case series study recruited patients from a single center diagnosed with DME with suboptimal response to anti-VEGF injections. Three consecutive monthly injections of aflibercept were performed. The primary outcome measure was mean change in visual acuity after switching to aflibercept.
RESULTS
Forty-two patients (42 eyes) were included. Baseline logarithm of the minimum angle of resolution (logMAR) visual acuity was 0.87 ± 0.23 and improved significantly to 0.62 ± 0.29, 0.56 ± 0.34, and 0.46 ± 0.35 at 1, 2, and 3 months, respectively, after the first injection. Mean baseline retinal thickness was 451.57 ± 107.09 µm and decreased significantly at 1, 2, and 3 months after switching to aflibercept (346.52 ± 79.03, 328.24 ± 81.98, and 313.71 ± 85.79 µm, respectively). Both visual improvement and mean change in retinal thickness were significant in patients with pre-aflibercept best-corrected visual acuity less than 1.0 logMAR but were not significant in patients with best-corrected visual acuity more than 1.0 logMAR.
CONCLUSIONS
Switching to aflibercept in DME patients with an unsatisfactory response to previous anti-VEGF injections provided acceptable short-term visual and retinal architectural improvement.

Keyword

Aflibercept; Diabetic retinopathy; Macular edema

MeSH Terms

Diabetic Retinopathy
Endothelial Growth Factors*
Humans
Macular Edema*
Outcome Assessment (Health Care)
Prospective Studies
Retinaldehyde
Visual Acuity
Endothelial Growth Factors
Retinaldehyde

Figure

• 

  Fig. 1 (A) Retinal architectural changes between baseline and (B) 3 months after switching to aflibercept injection. Though variable morphological changes were observed, overall anatomical improvement was achieved.

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