COMPARISON OF THE EFFICACY OF AFLIBERCEPT, BEVACIZUMAB, AND RANIBIZUMAB AFTER BEVACIZUMAB LOADING DOSES IN DIABETIC MACULAR EDEMA

Hasan Burhanettin KAPTı

Retina-Vitreus - 2026;35(2):138-144

Ordu University Faculty of Medicine, Department of Ophthalmology, Ordu, Türkiye

 

objective: This study aimed to evaluate the 12-month functional and anatomical outcomes of continuing bevacizumab, switching to aflibercept, or switching to ranibizumab following a three-dose bevacizumab loading regimen in the treatment of diabetic macular edema (DME). Materials and Methods: A total of 120 treatment-naïve patients with DME were included. After completing three loading doses of bevacizumab, patients were divided into three groups according to the subsequent anti-vascular endothelial growth factor (anti-VEGF) treatment: Group 1 received bevacizumab (n=40), Group 2 received aflibercept (n=40), and Group 3 received ranibizumab (n=40). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were compared at baseline and at months 3, 6, and 12. Results: All three groups demonstrated statistically significant BCVA improvement at all time points compared with baseline, whereas no significant differences were observed between the groups at any time point (p<0.001 and p=0.89, respectively). Baseline CMT values were 513.47 +/- 123.97 µm, 529.82 +/- 93.63 µm, and 486.63 +/- 81.56 µm for Groups 1, 2, and 3, respectively; at month 12, CMT values improved to 426.21 +/- 101.26 µm, 435.26 +/- 84.40 µm, and 407.18 +/- 83.63 µm, respectively. All groups showed significant CMT reduction from baseline (p<0.001). There was no significant difference in CMT change among the three groups at any time point (p=0.593). Conclusion: Following bevacizumab loading, continuation with bevacizumab or switching to aflibercept or ranibizumab provides comparable functional and anatomical improvement over a 12-month follow-up period in patients with DME.