Clinical evaluation of aflibercept or ranibizumab combined with laser therapy in patients with diabetic macular edema

Peng Cong; Zhou Changbo; Sun Liangliang; Zheng Wei; Ren Yao; Wang Bing

doi:10.3969/j.issn.1672-8157.2025.05.026

Abstract：Objective To explore the influence of aflibercept or ranibizumab on the basis of laser therapy on visual acuity re-covery and macular volume in patients with diabetic macular edema(DME).Methods A total of 98 patients with DME admitted to Putuo People's Hospital from January 2021 to December 2023 were selected and divided into the aflibercept group including 49 cases(86 eyes)and ranibizumab group of 49 cases(90 eyes)in by adopting random number table method.The patients in the aflibercept group received aflibercept on the basis of laser therapy,while those in the ranibizumab group were treated with ranibizumab on the basis of laser therapy.The clinical efficacy and visual acuity recovery status after treatment,clinical indicators(total macular volume(TMV),central foveal retinal thickness(CFT))before and after treatment and occurrence of complications during treatment were de-termined and compared between the two groups.Results The total effective rate in the aflibercept group was 96.51%(83/86)and it was higher than that of 87.78%(79/90)in the ranibizumab group(P<0.05).The best corrected visual acuity(BCVA)values in the aflibercept group and the ranibizumab group at 1,2 and 3 months of treatment were(0.48±0.16)logMAR,(0.32±0.09)logMAR,(0.21±0.03)logMAR,(0.54±0.20)logMAR,(0.36±0.12)logMAR and(0.24±0.08)logMAR,which were lower than those before treatment((0.75±0.19)logMAR,(0.77±0.23)logMAR).Meanwhile,the BCVA in the aflibercept group was smaller than that in the ranibizumab group at the above-mentioned time points,and the difference was statistically significant(F=10.670,P<0.05).By the end of treat-ment,the CFT and TMV were(271.02±21.98)μm and(8.93±1.27)mm3 in the aflibercept group and(282.38±25.35)μm and(9.52±1.49)mm3 in the ranibizumab group and they were lower than those before treatment((368.93±39.25)μm,(12.03±2.02)mm3,(369.71±38.11)μm,(12.11±2.14)mm3).Furthermore,these indicators were lower in the aflibercept group than in the ranibizumab group,and the differences were statistically significant(t=3.170,2.821,all P<0.05).The total incidence of adverse reactions was 4.08%(2/49)in the aflibercept group and 8.16%(4/49)in the ranibizumab group,showing no significant difference(χ2=0.710,P=0.399).Conclusion Compared with ranibizumab,aflibercept has more significant efficacy in the treatment of DME because it can reduce macular volume of the affected eye and promote visual acuity recovery and has better safety.