COMPARATIVE EFFICACY OF INTRAVITREAL BEVACIZUMAB AND RANIBIZUMAB IN THE TREATMENT OF DIABETIC MACULAR OEDEMA J.A. Montero, J.M. Ruiz-Moreno VISSUM, Alicante Institute of Ophthalmology, Vitreo-Retina Unit, Alicante Pio del Rio Hortega University Hospital, Ophthalmology Unit, Valladolid Department of Ophthalmology, Castilla La Mancha University, Albacete SPAIN

Introduction Diabetic macular oedema (DME) is the first cause of vision loss in diabetic patients DME may lead to degenerative retinal changes with permanent functional damage. PurposePurpose To report the comparative efficacy of intravitreal bevacizumab and ranibizumab in the treatment of DME.

Methods Interventional, case report series. Three patients who were on treatment for DME by monthly intravitreal ranibizumab in the right eye (RE), were started on treatment by intravitreal bevacizumab for DME in the left eye (LE). The patients were monthly evaluated by complete ocular examination, best corrected visual acuity (BCVA) performed by certified optometrists and central foveal thickness (CFT) as determined by Stratus Optical Coherence Tomography (OCT).

Results Right eyes treated by intravitreal ranibizumab showed a complete resolution of DME and significantly improved BCVA. DME recurred after two to three months requiring further injections. Left eyes showed a progression of DME and decreased BCVA while untreated. Intravitreal bevacizumab did not induce any significant change in macular thickness or BCVA and did not prevent DME progression. Intravitreal triamcinolone was used as rescue therapy in LE achieving reduction of CFT whereas moderate or no improvement in BCVA was observed.

Results # letters & CFT (x10 microns) # months Patient 1 RE CFT LE CFT RE BCVA LE BCVA Ranibizumab Bevacizumab Triamcinolone

Results OCT changes in CFT following ranibizumab, bevacizumab and triamcinolone as shown for patient #1. Baseline Month 1 Month 2 Month 3 Month 4 Month 3 Month 4 Month 2 Month 3 Month 4 Month 1 Month 2 Month 3 Month 4 Baseline Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 13

Results # letters & CFT (x10 microns) # months Patient 2 Ranibizumab Bevacizumab Triamcinolone RE CFT LE CFT RE BCVA LE BCVA

Conclusion Intravitreal ranibizumab seems to improve BCVA and macular thickness in DME.Intravitreal ranibizumab seems to improve BCVA and macular thickness in DME. Recurrences of DME makes it necessary to repeat intravitreal injections.Recurrences of DME makes it necessary to repeat intravitreal injections. Intravitreal bevacizumab does not seem to reduce macular thickness or improve visual function in patients with DME in whom good results had been observed after intravitreal ranibizumab.Intravitreal bevacizumab does not seem to reduce macular thickness or improve visual function in patients with DME in whom good results had been observed after intravitreal ranibizumab. The effect of intravitreal ranibizumab on the fellow eye in patients with DME seems to be negligible.The effect of intravitreal ranibizumab on the fellow eye in patients with DME seems to be negligible.