Comparison of efficacy of intravitreal ranibizumab and aflibercept in eyes with diabetic macular edema

Purpose To compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal aflibercept injection (IVA) injections on diabetic macular edema (DME). Methods The medical records of 49 eyes of 36 patients who were diagnosed with DME and had received IVR treatment from March to December 2014 and 46 eyes of 40 patients who had received IVA treatment from December 2014 to October 2015 were reviewed. The IVR and IVA were injected pro re nata. The central macular thickness and best‐corrected visual acuity (BCVA) were measured at 1, 3, and 6 months after the IVR or IVA. The mean number of injections of IVR injections was 2.6 ± 1.1 and of IVA was 2.7 ± 1.4. None of the clinical data, e.g., sex, age, HbA1c, BCVA, and CMT before treatment were significantly different between the IVR and IVA groups. Results The CMT was significantly thinner at 6 months after the IVR and the IVA (p < 0.05). The mean BCVA was significantly better only at 3 months after the IVR and at 1 and 6 months after the IVA (p < 0.05). The CMT of eyes with serous retinal detachment (SRD) was significantly thinner at 1 and 3 months after IVA, and at only at 6 months after IVR (p < 0.05). The BCVA of eyes with a SRD was significantly thinner at 6 months after the IVR, and at 1 and 6 months after the IVA (p < 0.05). In eyes with the previous IVR treatment, the CMT was significantly thinner during the observation period after the IVA but the BCVA was not significantly improved at any time after the IVA. Conclusions The effectiveness of IVA persists longer than that of IVR. The effectiveness of both IVR and IVA was not dependent on the presence of a SRD. We conclude that IVA may be effective in reducing the CMT in DM eyes refractory to IVR.