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Journal of Ophthalmology
Volume 2017 (2017), Article ID 8035013, 8 pages
Clinical Study

Switching to Aflibercept in Diabetic Macular Edema Not Responding to Ranibizumab and/or Intravitreal Dexamethasone Implant

1Ophthalmology Department, Avicenne Hospital, DHU Vision and Handicaps, Paris XIII University, 125 rue de Stalingrad, 93000 Bobigny, France
2Centre d’Imagerie et de Laser, 11 rue Antoine Bourdelle, Paris, France
3Ophthalmology Department, Pitié Salpétrière Hospital, DHU Vision and Handicaps, Paris VI University, Paris, France

Correspondence should be addressed to Audrey Giocanti-Auregan

Received 5 April 2017; Revised 19 June 2017; Accepted 16 July 2017; Published 16 August 2017

Academic Editor: Thomas Bertelmann

Copyright © 2017 Antoine Herbaut 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. To assess short-term functional and anatomical outcomes of refractory diabetic macular edema (DME) following a switch from ranibizumab or dexamethasone to aflibercept. Methods. We included retrospectively eyes with persistent DME after at least 3 ranibizumab and/or one dexamethasone implant intravitreal injections (IVI). The primary endpoint was the mean change in visual acuity (VA) at month 6 (M6) after switching. Results. Twenty-five eyes were included. Before switching to aflibercept, 23 eyes received a median of 9.5 ranibizumab, and among them, 6 eyes received one dexamethasone implant after ranibizumab and 2 eyes received only one dexamethasone implant. Baseline VA, before any IVI, was 52.9 ± 16.5 letters, and preswitch VA was 57.1 ± 19.6 letters. The mean VA gain was +8 letters () between preswitch and M6. The mean central retinal thickness was 470.8 ± 129.9 μm before the switch and 303.3 ± 59.1 μm at M6 (). Conclusion. Switching to aflibercept in refractory DME results in significant functional and anatomical improvement. The study was approved by the France Macula Federation ethical committee (FMF 2017-138).