For treatment of diabetic macular edema involving the center of the macula, 2-year outcomes are similar for those treated with aflibercept monotherapy and with bevacizumab followed by a switch to aflibercept in cases of suboptimal response, according to a study published in the New England Journal of Medicine. Chirag D. Jhaveri, MD, and colleagues randomly assigned eyes in adults with diabetic macular edema involving the macular center and a visual-acuity letter score of 24-69 to receive 2.0 mg of intravitreous aflibercept or 1.25 mg of intravitreous bevacizumab. Eyes in the bevacizumab group were switched to aflibercept beginning at 12 weeks if protocol-specified criteria were met. A total of 70% of the eyes in the bevacizumab-first group were switched to aflibercept therapy during the 2-year period. Mean improvements in visual acuity were 15.0 and 14.0 letters in aflibercept monotherapy and bevacizumab-first groups, respectively. At 2 years, the groups had similar mean changes in visual acuity and retinal central subfield thickness.
