Switching to ranibizumab in diabetic macular oedema refractory to bevacizumab treatment

Abstract Aim To determine the efficacy of switching to ranibizumab in patients with diabetic macular oedema refractory to treatment with bevacizumab, and to evaluate the outcomes when switching back to bevacizumab. Methods A prospective study was conducted that included 43 eyes of 31 patients refractory to previous bevacizumab treatment. The patients were switched to ranibizumab, and optical coherence tomography was performed one month post-injection. Patients showing improvement (>10% reduction in central sub-field thickness) were switched back to bevacizumab, and optical coherence tomography was performed one month post-switch back. Results The 34 eyes switched to ranibizumab showed a statistically significant improvement in mean best corrected visual acuity from 0.67 ± 0.39 logMAR to a mean of 0.55 ± 0.36 logMAR ( P P Conclusion Switching to ranibizumab in patients improves both the best corrected visual acuity and CST in diabetic patients refractory to previous bevacizumab treatment. This effect is pronounced in patients with increased CST prior to the switch. Switching back to bevacizumab adds no further improvement.