Switching to Aflibercept in Diabetic Macular Edema Not Responding to Ranibizumab and/or Intravitreal Dexamethasone Implant
Table 7
Subanalysis assessing functional and anatomical outcomes depending on treatment received before switch (ranibizumab monotherapy, dexamethasone monotherapy, or combined therapy).
N
Baseline
Preswitch
M3
M6
F
value (ANOVA test)
Visual acuity (letters on ETDRS chart)
Ranibizumab monotherapy median (min–max)
17
59 (15–74)
65 (37–85)
74 (35–85)
70 (50–85)
9.747
0.0002
Dexamethasone monotherapy median (min–max)
2
64 (54–74)
60 (46–74)
60 (35–85)
63.5 (44–83)
NA
NA
Combined therapy median (min–max)
6
39.5 (15–50)
43.5 (5–53)
54.5 (24–74)
54.5 (35–74)
2.5
0.15
valuea (comparison to baseline VA)
0.09
0.0002
0.0035
valueb (comparison to preswitch VA)
0.004
0.03
Central retinal thickness (μm)
Ranibizumab monotherapy median (min–max)
17
513 (376–831)
476 (315–660)
324 (208–388)
296
24.75
0.0001
Dexamethasone monotherapy median (min–max)
2
373 (306–440)
531 (366–696)
468 (313–623)
314.5 (299–330)
NA
NA
Combined therapy median (min–max)
6
540 (350–1088)
390.5 (327–677)
251.5 (204–420)
272.5 (208–388)
5.019
0.053
valuea (comparison to baseline CRT)
0.08
<0.0001
<0.0001
valueb (comparison to preswitch CRT)
<0.0001
<0.0001
F: result of variance test (ordinary one-way ANOVA). ANOVA test was performed to assess significance between VA or CRT at baseline, preswitch, M3, and M6 after switch to aflibercept within each group except for dexamethasone group (). a values were obtained after a paired nonparametric Wilcoxon test in comparison to baseline VA or CRT within the ranibizumab group; b values were obtained after a paired nonparametric Wilcoxon test in comparison to preswitch VA or CRT within the ranibizumab group. VA: visual acuity; CRT: central retinal thickness. <0.05; <0.01; <0.001; and <0.0001.
