This is a two-year randomised clinical trial of 660 patients with visual acuity impairment from diabetic macular oedema (DMO) who were randomised to monthly injections of 2.0mg aflibercept, 1.25 mg bevacizumab or 0.3mg ranibizumab. Focal or grid laser was performed after six months of persistent oedema. All three groups had decreased number of injections in year two. Additionally, all showed significant vision improvement from baseline. However, the improvement was least in the bevacizumab group, especially when compared against aflibercept. Ranibizumab had higher cardiovascular events over two years compared to the other two groups. What will be useful in the future is be an evaluation of the cost-effectiveness of the three different treatments for diabetic macular oedema. 

Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. Two-year results from a comparative effectiveness randomized clinical trial.
Wells JA, Glassman AR, Ayala AR, et al.
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Brian Ang

Royal Victorian Eye and Ear Hospital, Melbourne, Australia

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