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Switching to ranibizumab in diabetic macular oedema refractory to bevacizumab treatment.

Authors
  • Ashraf, M1
  • Souka, A A1
  • Daich Varela, M2
  • El Kayal, H1
  • Schlottmann, P G3
  • 1 Departamento de Oftalmología, Facultad de Medicina, Universidad de Alejandría, Alejandría, Egipto.
  • 2 Hospital Oftalmológico Santa Lucía, Buenos Aires, Argentina. , (Argentina)
  • 3 Departamento de Oftalmología, Organización Médica de Investigación, Buenos Aires, Argentina. Electronic address: [email protected] , (Argentina)
Type
Published Article
Journal
Archivos de la Sociedad Espanola de Oftalmologia
Publication Date
Nov 01, 2018
Volume
93
Issue
11
Pages
523–529
Identifiers
DOI: 10.1016/j.oftal.2018.04.001
PMID: 29861068
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

To determine the efficacy of switching to ranibizumab in patients with diabetic macular oedema refractory to treatment with bevacizumab, and to evaluate the outcomes when switching back to bevacizumab. A prospective study was conducted that included 43 eyes of 31 patients refractory to previous bevacizumab treatment. The patients were switched to ranibizumab, and optical coherence tomography was performed one month post-injection. Patients showing improvement (>10% reduction in central sub-field thickness) were switched back to bevacizumab, and optical coherence tomography was performed one month post-switch back. The 34 eyes switched to ranibizumab showed a statistically significant improvement in mean best corrected visual acuity from 0.67±0.39 logMAR to a mean of 0.55±0.36 logMAR (P<.05). In addition, there was a statistically significant decrease in central subfield thickness (CST) from a mean of 475.3±122.8 to a mean of 417.3±109.1 (P<.05). In the 21 eyes that were switched back to bevacizumab, there was no significant difference either in the change in CST or in the change in best corrected visual acuity post-switch back. Switching to ranibizumab in patients improves both the best corrected visual acuity and CST in diabetic patients refractory to previous bevacizumab treatment. This effect is pronounced in patients with increased CST prior to the switch. Switching back to bevacizumab adds no further improvement. Copyright © 2018 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

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