title: Ranibizumab for persistent diabetic macular edema after bevacizumab treatment.
abstract: OBJECTIVE
  To evaluate the efficacy of switching from bevacizumab to ranibizumab in patients with diabetic macular edema (DME).
  
  
  METHODS
  This was a retrospective study of patients with DME initially treated with bevacizumab and switched to ranibizumab. Visual acuity (VA) and central retinal thickness (CRT) were retrieved at fixed timepoints prior to and after the switch.
  
  
  RESULTS
  Forty eyes of 32 patients were included in the study. The difference in VA between any of these fixed timepoints was not statistically significant. A significant gain in VA was found in eyes that lost more than 0.1 logMAR during treatment with the last 3 bevacizumab injections. The mean CRT was significantly lower after the first 3 ranibizumab injections and at the final follow-up (p<0.001), a 67 ± 14 μm and 78 ± 18 μm reduction in thickness, respectively.
  
  
  CONCLUSIONS
  Switching to ranibizumab resulted in a significant decrease in the CRT of eyes with DME, and should be considered when there is a lack of response or deterioration while on bevacizumab injections. A significant gain in VA was observed in a subgroup of eyes that lost more than one line while receiving the last 3 bevacizumab injections prior to the switch.
authors.affiliation:  Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan; affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.| Assuta Medical Centers, Tel Aviv - Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Katz
authors.affiliation:  Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv; affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Moisseiev
authors.affiliation:  Assuta Medical Centers, Tel Aviv - Israel.| Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv; affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.
authors.forename: Dafna
authors.initials: D
authors.lastname: Goldenberg
authors.affiliation:  Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan; affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Moisseiev
authors.affiliation:  Maccabi Healthcare Services - Israel.
authors.forename: Yosef
authors.initials: Y
authors.lastname: Lomnicky
authors.affiliation:  Maccabi Healthcare Services - Israel.
authors.forename: Yitzchak
authors.initials: Y
authors.lastname: Abend
authors.affiliation:  Assuta Medical Centers, Tel Aviv - Israel.
authors.forename: Giora
authors.initials: G
authors.lastname: Treister
authors.affiliation:  Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan; affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.| Maccabi Healthcare Services - Israel.
authors.forename: Hani
authors.initials: H
authors.lastname: Levkovitch-Verbin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D012160:Retina / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab