Correlation between Diabetic Control and Visual Outcomes of Aflibercept versus Bevacizumab Therapy in Iraqi Patients with Diabetic Macular Edema
DOI:
https://doi.org/10.32947/ajps.v26i1.1385Keywords:
Aflibercept, Bevacizumab, Blood Glucose, Macular Edema, Glycated Hemoglobin A, Diabetic RetinopathyAbstract
Background: Diabetic retinopathy represents a significant burden on the public healthcare system in Iraq. While anti-vascular endothelial growth factor (anti-VEGF) agents have revolutionized management. However, a limited number of studies on the effectiveness of these agents and their comparison in Iraqi patients.
Aim: This study aims to evaluate the clinical outcomes of intravitreal aflibercept compared to bevacizumab in Iraq.
Methods: A prospective study was conducted at the Department of Ophthalmology, Ghazi al-Hariri Surgical Hospital, Baghdad Medical City, from June 2024 to September 2025, involving 120 patients (169 eyes). Participants were stratified into two groups: Group A received aflibercept (n=53), and Group B received bevacizumab (n=67). Baseline pretreatment data and data collected one month after the third anti-VEGF dose were collected. Visual acuity (VA), measured by LogMar, and central subfield thickness (CST) are the main clinical outcomes. Baseline pretreatment glycated hemoglobin was recorded, and one month posttreatment.
Results: Both groups demonstrated significant functional and anatomic improvements (p-value < 0.001 in all arms); however, aflibercept showed superior anatomic outcomes (ΔCST: 19.51% vs. 14.14%, p-value < 0.001, for IVA and IVB, respectively) and visual gains (ΔLogMAR: 0.188 ± 0.126 vs. 0.139 ± 0.120, p-value 0.011, for Group A and Group B, respectively). The anti-VEGF agents were effective independently of the glycemic control.
Conclusion: Aflibercept was clinically superior to bevacizumab.
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