First Author: Y.Toklu TURKEY
Co Author(s): M. Arikan Yorgun M. Mutlu M. Kars
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To evaluate the results of intravitreal aflibercept injection in cases with diabetic macular edema refractory to intravitreal ranibizumab injections.
The charts of 32 patients that received intavitreal (iv) aflibercept injection due to persistent diabetic macular edema (DME) in Yıldırım Beyazıt University Ataturk Education and Research Hospital retina department reviewed retrospectively.
Patients with no response to at least 3 iv ranibuzumab injections for DME were enrolled into the study. The injection protocol of these 32 patients was switched to iv aflibercept injection. Central macular thickness (CMT) and best corrected visual acuity (BCVA) tested by Snellen chart were noted before and after 1st, 2nd and 3rd months of iv aflibercept injection. Type of diabetes mellitus (DM), HbA1c levels, lens status, number of iv injections and other treatments before switch were also noted.
The mean age of study group was 61.9±8.6 (36-73) years. Among the subjects 16 of them were female and 16 of them were male. Patients having type 1 DM were 15 and type 2 DM were 17 in number. The mean HbA1c level was 7.4±0.9 (6.7-9.0). Twelve patients were phakic and 20 patients were pseudophakic. The mean of IV ranibuzumab injection before switch was 5.5±2.7 (3-13). Six patients had focal macular laser, 6 patients had pars plana vitrectomy surgery and 16 patients had panretinal photocoagulation at least 6 months before the switch. The mean BCVA before the switch was 0.43, 1st month after switch was 0.44, at 2nd month was 0.48 and 0.63 at 3rd month (p>0.05). The mean CMT before the switch was 406.92 µm, 1st month after switch was 348.22 µm, at 2nd month was 323.17 µm and 353.29 µm at 3rd month. The decrease in the CMT was statistically significant 1st month after IV aflibercept injection (p<0.05).
In our study, after switch from IV ranibuzumab to IV aflibercept injection we had a successful anatomic result in short term. Whereas functional improvement was not statistically significant.