In the DRCR Protocol T comparison of aflibercept, bevacizumab and ranibizumab for center-involving diabetic macular edema, one clear subgroup difference emerged in visual outcomes. Anti-VEGF therapy produced the greatest advantage with which agent, and in which subgroup?
- A Bevacizumab, in eyes with baseline acuity better than 20/40
- B Ranibizumab, in pseudophakic eyes regardless of baseline acuity
- C Aflibercept, in eyes with baseline acuity worse than 20/40 ✓
- D All three agents were identical across every subgroup studied
Correct answer: C. Aflibercept, in eyes with baseline acuity worse than 20/40
Explanation
Protocol T found the three drugs broadly comparable overall, but among eyes starting with visual acuity worse than 20/40, aflibercept gave significantly greater mean gain at one year than either bevacizumab or ranibizumab. When baseline vision was 20/40 or better, the agents performed similarly. Option D is wrong because this subgroup effect was real and reproducible at two years, making it the memorable teaching point of the trial.
Reference: AAO Basic and Clinical Science Course, Section 12: Retina and Vitreous, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.