{
  "abstract": "Background/aims To describe the functional outcomes of patients with diabetic macular oedema (DME) non-responsive to bevacizumab switched to ranibizumab or aflibercept over 1 year and the demographic and anatomic predictors of these functional outcomes.Methods In a retrospective real-world cohort study, 76 consecutive patients with DME non-responsive to bevacizumab were reviewed at baseline and 12 months after switch to ranibizumab or aflibercept. Visual acuity (VA) and optical coherence tomography features such as central retinal thickness were assessed. Multiple logistic regression was performed to determine predictors for outcomes.Results From baseline to 1 year, the overall best-corrected VA improved by LogMAR 0.015±0.19 with no difference between patients who switched to ranibizumab or aflibercept (LogMAR 0.017±0.21 vs LogMAR 0.013±0.17, p=0.92). Ranibizumab patients had more reduction in central subfield thickness (CST) (390.13 µm vs 334.20 µm, p=0.033) than aflibercept patients. Baseline HbA1c (p=0.012) and number of bevacizumab injections (p=0.040) were significantly associated with gain in VA, while change in CST was a strong predictor of VA change (p<0.01). Aflibercept patients were more likely to gain vision after 6 months but not at 12 months.Conclusions In a real-world study, improvements in functional outcomes can still be gained after switching anti-vascular endothelial growth factor in bevacizumab non-responders. Both ranibizumab and aflibercept were comparable and effective treatments.",
  "authors": [
    {
      "affiliations": [
        "Ophthalmology, Woodlands Health, Singapore",
        "National Healthcare Group Eye Institute, Singapore"
      ],
      "name": "Louis W Lim"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Darren Choy"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Wen Jun Song"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore",
        "Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore",
        "Hebei Provincial Eye Hospital, Hebei, People's Republic of China"
      ],
      "name": "Wei Kiong Ngo"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Zheng Xian Thng"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Helen Fang Mi"
    },
    {
      "affiliations": [
        "Ophthalmology, Woodlands Health, Singapore",
        "National Healthcare Group Eye Institute, Singapore"
      ],
      "name": "Yu Qiang Soh"
    },
    {
      "affiliations": [
        "Ophthalmology, Woodlands Health, Singapore",
        "National Healthcare Group Eye Institute, Singapore"
      ],
      "name": "Koh Lilian"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Jacob Yu Hang Chin"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Karen Jhi Wen Chia"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Augustinus Laude"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Colin S Tan"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Tock Han Lim"
    },
    {
      "affiliations": [
        "Novartis AG, Singapore"
      ],
      "name": "Issac Too"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Nicola Y Gan"
    },
    {
      "affiliations": [
        "National Healthcare Group Eye Institute, Singapore",
        "Ophthalmology, Tan Tock Seng Hospital, Singapore"
      ],
      "name": "Rajesh Rajagopalan"
    }
  ],
  "title": "Anti-VEGF treatment switch in real-world DME patients: ranibizumab versus aflibercept for bevacizumab DME non-responding patients (SWIRL study)",
  "uid": "51304f8d-2cc1-5f9a-9595-3f17f582a7db"
}