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Purpose <p>The efficacy and safety of Aflibercept (AFL) 2&#xa0;mg versus Brolucizumab (BRZ) 6&#xa0;mg in diabetic macular edema (DME) were evaluated in this retrospective comparative research.</p> Patients and methods <p>Thirty-eight eyes with DME for &gt; 18 months were retrospectively reviewed and divided equally. Group A received three loading doses of intravitreal BRZ (6&#xa0;mg) and Group B received five loading doses of intravitreal AFL (2&#xa0;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.</p> Results <p>Thirty-eight eyes were analyzed (19 per group). At six months, BCVA and CMT improvements were comparable (<i>p</i> &gt; 0.05). At 12 and 18 months, BRZ achieved significantly greater BCVA gain (0.17 ± 0.08 vs. 0.34 ± 0.11 logMAR, <i>p</i> &lt; 0.001) and greater CMT reduction (239.5 ± 12.5&#xa0;μm vs. 263.2 ± 19.8&#xa0;μm, <i>p</i> &lt; 0.001) compared with AFL. The BRZ group had a considerably lower mean total number of injections (5 ± 1.2 vs. 9 ± 1.3, <i>p</i> &lt; 0.001), representing a 44% reduction in injection burden. A mild, non-vision-threatening retinal vasculitis occurred in one BRZ patient (5.3%, <i>p</i> = 0.4866).</p> Conclusion <p>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.</p>

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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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  • 发表日期：

    2026年4月17日

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  • Ehab Mohamed Elsayed Saad,
  • Wafaa Kamel Abdelmoneim Abdelmaged,
  • Ahmed Alyan,
  • Sherif A. Dabour,
  • Ahmed Abdelshafy Tabl

摘要

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.