Comparative study between ranibizumab and aflibercept in the management of macular edema caused by diabetes mellitus in age group more than 40 years

Abstract

Background Diabetic macular edema (DME) is a common cause of blindness and visual impairment in diabetic patients, which can affect the quality of life. Aflibercept and ranibizumab are used as intravitreal anti-vascular endothelial growth factor injections; both of them have a relatively safe effective treatment of DME.Aim of the work To compare the effect of aflibercept and ranibizumab in the management of DME.Patients and methods A prospective invasive and nonrandomized study, including 20 eyes in 20 patients, more than 40 years old, was conducted in Al-Azhar Faculty of Medicine, Cairo, with three times injections 1 month apart. Eyes were divided into two groups: group A included 10 patients who received ranibizumab 0.5 mg (0.05 ml of 10 mg/ml solution) as an intravitreal injection, and group B included 10 patients who received aflibercept 2 mg (0.05 ml of 40 mg/ml solution) as an intravitreal injection. Follow-up period was 4 months.Results A statistically significant improvement of best-corrected visual acuity (BCVA) and central macular thickness with ranibizumab was reported over the follow-up period. There was also a statistically significant improvement of BCVA, central macular thickness, and intraocular pressure over the follow-up visits with aflibercept. Ranibizumab was more effective in BCVA correction and in the reduction of central macular thickness than aflibercept.Conclusion Both ranibizumab and aflibercept are effective in improving the BCVA and in the reduction of central macular thickness. Ranibizumab is more effective for BCVA correction and in the reduction of central macular thickness than afliberceptRecommendations Further studies are needed to confirm the effect of ranibizumab and aflibercept intravitreal injection on the central macular thickness and intraocular pressure.