Switch to Aflibercept in Diabetic Macular Edema Patients Unresponsive to Previous Anti-VEGF Therapy

Purpose. the aim was to evaluate the efficacy of aflibercept in patients with diabetic macular edema (dme) unresponsive to prior anti-vegf therapy. methods. retrospective review of dme unresponsive to previous anti-vegf switched to aflibercept with 3 months of follow-up. changes in best correct visual acuity (bcva),central retinal thickness (crt),and frequency of injections were analyzed. the percentage of subjects who had ≥20/40 (logmar equivalent 0.3) and ≤20/200 (logmar equivalent 1) was evaluated. results. a total of 32 eyes from 26 patients were included. mean age was 65 ± 10 years old. the mean number of previous anti-vegf injections was 5.34 ± 2.38,and the mean number of aflibercept injections at the end of the study was 2.00 ± 0.00. the crt at baseline was 501.47 ± 150.51 μm and 367.97 ± 124.61 μm at 3 months of follow-up (p<0.001). the logmar bcva at baseline was 0.71 ± 0.36 and 0.65 ± 0.33 at the end of the follow-up (p=0.037). at baseline,12.5% of patients had ≥20/40 compared with 25% at the end of follow-up. at baseline,28.13% of patients had 20/200 or inferior vision compared with 15.63% at the end of the follow-up. conclusions. dme patients unresponsive to previous multiple ranibizumab injections demonstrate a significant anatomical and functional improvement with the switch to aflibercept. © 2017 filipe mira et al.