title: Short-Term Outcomes of Switching to Ranibizumab Therapy for Diabetic Macular Edema in Patients with Persistent Fluid After Bevacizumab Therapy.
abstract: To evaluate the efficacy of switching from bevacizumab to ranibizumab in patients with diabetic macular edema (DME).
  
  
  
  Patients with DME who showed persistent fluid after at least 3 monthly bevacizumab injections were administered a single ranibizumab injection and were followed up after 1 month. Anatomic responders to ranibizumab were followed up monthly and administered ranibizumab injections on an as-needed basis for 3 months.
  
  
  
  At the 1-month follow-up, mean central subfield foveal thickness (CSFT) decreased from 422 to 346 μm (P < 0.001) and mean best-corrected visual acuity (BCVA) improved from 20/49 to 20/46 (P = 0.063) in 62 enrolled eyes. Thirty-nine eyes (62.9%) were classified as anatomical responders and, after repeated ranibizumab injections (mean number: 2.6), mean CSFT improved (429-317 μm, P < 0.001) while BCVA was stabilized (20/52 to 20/48, P = 0.066) after 3 months, compared with baseline. The rate of patients who showed partial response to previous bevacizumab between anatomical responders and nonresponders to ranibizumab was compared. The results showed that the rate was significantly higher in the responder group than nonresponder group (76.9% vs. 43.5%, P = 0.008).
  
  
  
  Switching patients to ranibizumab may present a suitable option for the treatment of DME with persistent fluid after repeated bevacizumab injections. This treatment switch was more effective in eyes that showed partial response to previous bevacizumab therapy, compared with nonresponsive eyes.
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: VEGF; diabetic macular edema; diabetic retinopathy; steroids