In diabetic macular edema, the DRCR.net Protocol T trial directly compared three anti-VEGF agents. The trial found that at 1 year, which agent was statistically superior for eyes with baseline visual acuity of 20/50 or worse?
- A Ranibizumab 0.3 mg
- B Bevacizumab 1.25 mg
- C Aflibercept 2.0 mg ✓
- D All three were statistically equivalent across all baseline VA levels
Correct answer: C. Aflibercept 2.0 mg
Explanation
The DRCR.net Protocol T trial compared aflibercept 2 mg, ranibizumab 0.3 mg, and bevacizumab 1.25 mg for diabetic macular edema at 1 and 2 years. In eyes with baseline VA of 20/50 or worse (moderate vision loss), aflibercept demonstrated statistically superior visual gains at 1 year compared to bevacizumab (not ranibizumab). In eyes with baseline VA of 20/32–20/40 (good baseline), all three agents performed equivalently. This established aflibercept as the preferred agent for patients with DME and moderate baseline vision loss.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.