First Author: T.Georgouli UK
Co Author(s): S. Mackenzie G. Walters
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The purpose of this study was to evaluate the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular oedema (DMO) in a real-life clinical setting.
The study was conducted at the Ophthalmology Department of Harrogate District Foundation National Health Service Trust.
All DMO patients treated with either ranibizumab or aflibercept between January 2013 and January 2017 were included in the study. Exclusion criteria included patients who received other anti-vascular endothelial growth factors or patients who were converted from ranibizumab to aflibercept and vice versa, as well as patients with insufficient follow-up. The results from the clinical records, as well the central retinal thickness (CRT) from optical coherence tomography (OCT) scans were analysed. All patients received a loading dose of 3 monthly injections followed by further injections as per required need. The visual acuity gain and the change in central retinal thickness at 6, 12 and 24 months were analysed. Secondary endpoints were the number of intravitreal injections at 24 months for the ranibizumab group and at 6 months for the aflibercept group.
In total 50 eyes of 36 patients were included (22 eyes treated with ranibizumab and 28 eyes treated with aflibercept). A mean number of 5.9 injections were administered in the first 6 months in the aflibercept group and 12 injections at 24 months in the ranibizumab group. In the ranibizumab group the median letter gain was 6 letters at 6 months, 7 letters at 12 months and 3 letters at 24 months from baseline. There was a statistically significant reduction of the CRT by 34% from baseline at 6 months, 40% at 12 months and 43% at 24 months. In the aflibercept group there was a mean letter gain of 10.75 at 6 months (p<0.005) and a 37% reduction of the CRT from baseline (p<0.01).
Both ranibizumab and aflibercept appear to be effective in the clinical setting for the treatment of diabetic macular oedema, confirming the results of previous randomised trials.