The Effectiveness of Intravitreal Ranibizumab in Patients with Diabetic Macular Edema Who Have Failed to Respond to Intravitreal Bevacizumab

Purpose: To investigate the response to intravitreal ranibizumab after failure of intravitreal bevacizumab in patients with diabetic macular edema (DME). Methods: Demographics, visual acuity (VA), central macular thickness (CMT), and HbAic were retrospectively collected from DME patients treated with second-line intravitreal ranibizumab at a tertiary hospital in 2012-2013 and followed for at least 3 months. Results: Twenty-two patients (26 eyes) were included in the study, with a mean (+/- SD) age of 66 +/- 8.1 years and followed for an average of 28.36 months. The mean number of intravitreal bevacizumab injections was 7.3 +/- 2.8, and of intravitreal ranibizumab injections 5.11 +/- 2.4. After 3 ranibizumab injections, 57% of eyes showed improvement in VA. The change in VA was statistically significant (p = 0.044) in those eyes where the pretreatment acuity for the second-line therapy was <20/40 (logMAR 0.3). CMT decreased from 435.95 +/- 83.28 to 373.69 +/- 44.39 mu m (p = 0.01). The number of ranibizumab injections was significantly correlated with the change in CMT (p = 0.037). Conclusion: Intravitreal treatment with ranibizumab can be efficacious in eyes with DME that have failed to respond to bevacizumab. (C) 2016 S. Karger AG, Basel