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Journal of Ophthalmology
Volume 2017 (2017), Article ID 5632634, 4 pages
Clinical Study

Switch to Aflibercept in Diabetic Macular Edema Patients Unresponsive to Previous Anti-VEGF Therapy

1Centro Hospitalar Médio Tejo, Tomar, Portugal
2Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
3Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
4Associação para a Investigação Biomédica e Inovação em Luz e Imagem, Coimbra, Portugal

Correspondence should be addressed to Filipe Mira; moc.liamg@arierrefarimepilif

Received 3 October 2016; Accepted 16 January 2017; Published 1 March 2017

Academic Editor: Lisa Toto

Copyright © 2017 Filipe Mira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The aim was to evaluate the efficacy of aflibercept in patients with diabetic macular edema (DME) unresponsive to prior anti-VEGF therapy. Methods. Retrospective review of DME unresponsive to previous anti-VEGF switched to aflibercept with 3 months of follow-up. Changes in best correct visual acuity (BCVA), central retinal thickness (CRT), and frequency of injections were analyzed. The percentage of subjects who had ≥20/40 (logMAR equivalent 0.3) and ≤20/200 (logMAR equivalent 1) was evaluated. Results. A total of 32 eyes from 26 patients were included. Mean age was 65 ± 10 years old. The mean number of previous anti-VEGF injections was 5.34 ± 2.38, and the mean number of aflibercept injections at the end of the study was 2.00 ± 0.00. The CRT at baseline was 501.47 ± 150.51 μm and 367.97 ± 124.61 μm at 3 months of follow-up (). The logMAR BCVA at baseline was 0.71 ± 0.36 and 0.65 ± 0.33 at the end of the follow-up (). At baseline, 12.5% of patients had ≥20/40 compared with 25% at the end of follow-up. At baseline, 28.13% of patients had 20/200 or inferior vision compared with 15.63% at the end of the follow-up. Conclusions. DME patients unresponsive to previous multiple ranibizumab injections demonstrate a significant anatomical and functional improvement with the switch to aflibercept.