A real-world study has found that patients with diabetic macular oedema (DME) unresponsive to bevacizumab can still achieve visual improvements after switching to ranibizumab or aflibercept.
Researchers reviewed 76 patients over 1 year following the switch. Visual acuity gains were modest and similar between the drugs, but ranibizumab led to a greater reduction in central subfield thickness. Baseline HbA1c levels, the number of prior bevacizumab injections, and changes in retinal thickness were significant predictors of visual improvement.
Although patients on aflibercept were more likely to experience vision gains at 6 months, both treatments showed comparable effectiveness at 12 months.
Reference
Lim LW, Choy D, Song WJ, et al. Anti-VEGF treatment switch in real-world DME patients: ranibizumab versus aflibercept for bevacizumab DME non-responding patients (SWIRL study). BMJ Open Ophthalmol. 2025;10(1):e002178. doi: 10.1136/bmjophth-2025-002178. PMID: 40750300; PMCID: PMC12314985.
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