The efficacy of Intravitreal Brolucizumab versus Aflibercept in The Treatment of Diabetic Macular Edema | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 142, Volume 100, Issue 1, July 2025, Page 3531-3537 PDF (320.6 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.446648 | ||||
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| Abstract | ||||
| Background: Diabetes patients frequently develop diabetic macular edema (DME), a microvascular complication that has become the leading cause of vision loss among the working adult population. In the diabetic retina, oxidative stress and chronic hyperglycemia lead to the upregulation of vascular endothelial growth factor (VEGF), which increases vascular permeability and breakdown of the inner blood-retinal barrier. Objective: To compare the effect of intravitreal injection of brolucizumab and aflibercept (Eylea) in DME. Patients and methods: The study was a randomized comparative prospective study that involved 62 eyes from 31 patients with DME who were randomly allocated into two groups using alternate assignment. Eyes in group I were treated with intravitreal injection of 2mg/0.05 mL aflibercept and eyes in group II were treated with intravitreal injection of 6mg/0.05 mL brolucizumab. Results: Central macular thickness (CMT) was significantly lower at 3 months (277 ± 74.11 μm, 346.6±244.61 μm) and at 1 month (381.5±98.46 μm, 424.27±208.1 μm) compared to baseline (519.13±99.69 μm, 576.53±163.97 μm) in the aflibercept (Eylea) and brolucizumab groups, respectively (P < 0.05). It is worth noting that CMT decreased significantly more in the aflibercept group compared to the brolucizumab group. Vision was significantly lower after 3 months (0.13±0.11, 0.27±0.28) and at 1 months (0.36±0.12, 0.45±0.18) compared to before injection (0.55 ±0.06, 0.60±0.15) among aflibercept (eylea) and Brolucizumab groups respectively (P<0.05), it is worth to mentioned that, the vision was significantly more decreased after injection among aflibercept (eylea) group compared to Brolucizumab group. Although complications were observed, there was no statistically significant difference in their incidence between the aflibercept and brolucizumab groups (P > 0.05). Conclusion: Both central macular thickness (CMT) and best-corrected visual acuity (BCVA) improved following treatment. However, brolucizumab has been associated with a higher risk of intraocular inflammation, retinal vasculitis, and retinal vascular occlusion. The relative efficacy of anti-VEGF agents appears to depend on baseline visual acuity, highlighting the importance of individualized treatment selection. | ||||
| Keywords | ||||
| Intravitreal Brolucizumab; Aflibercept; DME; VEGF | ||||
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