Comparison of intravitreal ranibizumab, aflibercept and bevacizumab therapies in diabetic macular edema with serous retinal detachment

Eur J Ophthalmol. 2023 May;33(3):1459-1466. doi: 10.1177/11206721221144797. Epub 2022 Dec 8.

Abstract

Purpose: To compare the effects of ranibizumab, aflibercept and bevacizumab treatments in treatment-naive diabetic macular edema(DME) patients with serous retinal detachment(SRD).

Material and methods: This is a retrospective, comparative study. In a sample of 86 eyes of 86 untreated DME patients with accompanying SRD, 23 patients were treated with ranibizumab (IVR), 28 patients with aflibercept (IVA), and 35 patients with bevacizumab (IVB). All were injected intravitreally once a month for a 3-month loading dose. Subsequently, all participants were evaluated every months and if neccessary they received additional intravitreal treatments.Mean changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), and SRD height over the 6-months study period were compared.

Results: At baseline, the groups did not differ in mean BCVA,CRT and SRD height. During the first 3 months, in IVA group the mean decrease in CRT and SRD height were significantly more than in the other two groups (p < 0.05 for all). However, these differences disappeared at 6 months.The number of injections was similar between the groups during the study period.

Conclusion: In patients with DME accompanied by SRD, IVA is a more advantageous option in terms of reduction in CRT and SRD height from baseline to 3 months. In the 6-month period of treatment, IVR, IVA and IVB therapies areanatomically and functionally similar and significant effective modalities.

Keywords: aflibercept; bevacizumab; diabetic macular edema; ranibizumab; serous retinal detachment.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Diabetes Mellitus* / drug therapy
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Ranibizumab / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use
  • Retinal Detachment* / diagnosis
  • Retinal Detachment* / drug therapy
  • Retinal Detachment* / etiology
  • Retrospective Studies
  • Visual Acuity

Substances

  • Ranibizumab
  • Bevacizumab
  • aflibercept
  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins