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

Figures & data

Table 1 Central Macular Thickness in Eyes with Refractory Diabetic Macular Edema Before and After Three Injections of Anti-Vascular Growth Factors as Second Line of Treatment After 3 to 6 Intravitreal Injections of Bevacizumab

	Ranibizumab Treatment Regimen		Aflibercept Treatment Regimen		Mean Difference (95% CI) p-value
	Mean (µ)	SDV (µ)	Mean (µ)	SDV (µ)
Before treatment	514.5	148.6	453.2	127.2	61.3 (18.2; 104.3) p = 0.006
After treatment regimen	424.3	129.1	353.9	112.5	70.4 (32.8; 108.8) p <0.001
Matched pair analysis: Mean difference (95% CI) P value	90.6 (62.5; 117.8) p <0.001		99.3 (74.7; 123.9) p <0.001

Table 2 Visual Impairment Grades in Eyes with Refractory Diabetic Macular Edema Before and After Three Injections of Anti-Vascular Growth Factors as Second Line of Treatment After 3 to 6 Intravitreal Injections of Bevacizumab

		Ranibizumab Treatment Regimen		Aflibercept Treatment Regimen		Validation
		Number	Percentage	Number	Percentage
Before treatment	20/20 to 20/60	37	45.7	32	40.0	χ^2 = 0.4 df = 4 p = 0.7
	<20/60 to 20/200	32	39.5	43	53.8
	<20/200 to 20/400	10	12.3	5	6.3
	<20/400	2	2.5	0	0.0
After treatment regimen	20/20 to 20/60	36	44.4	36	45	χ^2 = 0.02 df = 4 p = 0.9
	<20/60 to 20/200	36	44.4	36	45
	<20/200 to 20/400	8	9.9	8	10
	<20/400	1	1.2	0	0
Validation		χ^2 = 0.05 df = 4 p = 0.8		χ^2 = 0 df = 4 p = 1

Table 3 Predictors of Reduction of Central Macular Thickness Following Anti-Vascular Growth Factor Treatment Regimen in Eyes with Refractory Diabetic Macular Edema After 3 to 6 Intravitreal Injections of Bevacizumab

	Unstandardized Coefficients	Standardized Coefficients (B)	95% Confidence Interval of B	Two-sided p-value
Constant	203.7		49.1; 358.2	0.010
Type of anti-VEGF treatment regimen	−47.2	−0.196	−94.5; 0.1	0.050
CMT before treatment regimen	−0.5	−0.538	−0.6; −0.3	0.000
Grade of diabetic retinopathy	12.6	0.108	−10.0; 36.0	0.290
Duration of diabetes	−3.0	−0.167	−6.5; 0.5	0.093
Number of bevacizumab injection in past	11.2	0.149	−3.3; 25.8	0.130