Switching between anti-VEGF agents in the management of refractory diabetic macular edema: A systematic review

Refractory diabetic macular edema (DME) to monthly intravitreal anti-vascular endothelial growth factor (VEGF) monotherapy has a prevalence of approximately 40% in landmark clinical trials. Options for these patients include use of intravitreal steroids, focal laser, or switching to an alternative anti-VEGF agent. We summarize the key conclusions from studies analyzing the efficacy of switching anti-VEGF agents for refractory DME. Twenty-four studies were included in analysis. The most common definitions of refractory in the included studies were a central retinal thickness (CRT) greater than 300 μm or a reduction in CRT less than 10% after at least 3-6 prior anti-VEGF injections.
Source: Survey of Ophthalmology - Category: Opthalmology Authors: Source Type: research