Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
Evaluating the efficacy and safety of brolucizumab versus aflibercept on visual and anatomical outcomes in diabetic macular edema: a retrospective comparative study.
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Saad Ehab Mohamed Elsayed, Abdelmaged Wafaa Kamel Abdelmoneim, Alyan Ahmed, Dabour Sherif A, Tabl Ahmed Abdelshafy
Аннотация
PURPOSE: The efficacy and safety of Aflibercept (AFL) 2 mg versus Brolucizumab (BRZ) 6 mg in diabetic macular edema (DME) were evaluated in this retrospective comparative research.
PATIENTS AND METHODS: Thirty-eight eyes with DME for > 18 months were retrospectively reviewed and divided equally. Group A received three loading doses of intravitreal BRZ (6 mg) and Group B received five loading doses of intravitreal AFL (2 mg), followed by pro re nata (PRN) dosing per OCT-detected persistent macular edema. The central macular thickness (CMT) change from baseline was the main outcome measure. Injection count, complication rate, and best-corrected visual acuity (BCVA) were the secondary objectives.
RESULTS: Thirty-eight eyes were analyzed (19 per group). At six months, BCVA and CMT improvements were comparable (p > 0.05). At 12 and 18 months, BRZ achieved significantly greater BCVA gain (0.17 ± 0.08 vs. 0.34 ± 0.11 logMAR, p < 0.001) and greater CMT reduction (239.5 ± 12.5 μm vs. 263.2 ± 19.8 μm, p < 0.001) compared with AFL. The BRZ group had a considerably lower mean total number of injections (5 ± 1.2 vs. 9 ± 1.3, p < 0.001), representing a 44% reduction in injection burden. A mild, non-vision-threatening retinal vasculitis occurred in one BRZ patient (5.3%, p = 0.4866).
CONCLUSION: BRZ provided superior visual and anatomical outcomes compared with AFL at 12 and 18 months, with significantly fewer injections. Both agents demonstrated acceptable safety profiles. With a lower treatment burden and long-lasting effectiveness in practical situations, our results validate BRZ as a viable and long-lasting therapy option for DME.
PATIENTS AND METHODS: Thirty-eight eyes with DME for > 18 months were retrospectively reviewed and divided equally. Group A received three loading doses of intravitreal BRZ (6 mg) and Group B received five loading doses of intravitreal AFL (2 mg), followed by pro re nata (PRN) dosing per OCT-detected persistent macular edema. The central macular thickness (CMT) change from baseline was the main outcome measure. Injection count, complication rate, and best-corrected visual acuity (BCVA) were the secondary objectives.
RESULTS: Thirty-eight eyes were analyzed (19 per group). At six months, BCVA and CMT improvements were comparable (p > 0.05). At 12 and 18 months, BRZ achieved significantly greater BCVA gain (0.17 ± 0.08 vs. 0.34 ± 0.11 logMAR, p < 0.001) and greater CMT reduction (239.5 ± 12.5 μm vs. 263.2 ± 19.8 μm, p < 0.001) compared with AFL. The BRZ group had a considerably lower mean total number of injections (5 ± 1.2 vs. 9 ± 1.3, p < 0.001), representing a 44% reduction in injection burden. A mild, non-vision-threatening retinal vasculitis occurred in one BRZ patient (5.3%, p = 0.4866).
CONCLUSION: BRZ provided superior visual and anatomical outcomes compared with AFL at 12 and 18 months, with significantly fewer injections. Both agents demonstrated acceptable safety profiles. With a lower treatment burden and long-lasting effectiveness in practical situations, our results validate BRZ as a viable and long-lasting therapy option for DME.