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Switching to ranibizumab for diabetic macular edema with persistent fluid on bevacizumab: Who is likely to benefit from the switch?
Author(s) -
Lee J.H.,
Lee W.K.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0421
Subject(s) - ranibizumab , medicine , bevacizumab , ophthalmology , diabetic macular edema , visual acuity , diabetic retinopathy , surgery , diabetes mellitus , chemotherapy , endocrinology
Purpose To evaluate the efficacy of switching from bevacizumab to ranibizumab in patients with diabetic macular edema ( DME ). Methods The medical records of 41 DME eyes which showed persistent fluid after at least three monthly bevacizumab injections, and switched to ranibizumab injection were reviewed. Each patient received a single ranibizumab injection and followed up at 1 month. Anatomic responders to ranibizumab were followed up monthly and given ranibizumab injections on an as‐needed basis until 3 months. Results At 1 month, the mean central foveal thickness ( CFT ) decreased from 431 μ m to 349 μ m (P < .001), and mean best‐corrected visual acuity ( BCVA ) improved from 20/53 to 20/48 (P = .062). Twenty‐six eyes (65.9%) were classified as anatomical responders, and the mean CFT improved and maintained until 3 months (439 μ m to 320 μ m, P < .001) after repeated injections (mean number: 2.8), while the mean BCVA stabilized (20/59 to 20/54, P = .075) in these eyes. Dry macula were achieved in 9 of 26 eyes at least once during the follow‐up period. Favorable anatomic response to ranibizumab at month 1 was related with previous partial response to bevacizumab. Conclusions Switching to ranibizumab may present an alternative option in the treatment of DME with persistent fluid after repeated bevacizumab injections, and the switch was more effective in eyes that showed partial response to previous bevacizumab.