A 58-year-old woman with center-involving diabetic macular edema has best corrected visual acuity of 6/60 in the study eye. Based on the DRCR Protocol T results, which intravitreal agent gave the best visual outcome at 1 year for eyes starting with visual acuity of 20/50 or worse?
- A Bevacizumab
- B Aflibercept ✓
- C Ranibizumab
- D Triamcinolone acetonide
Correct answer: B. Aflibercept
Explanation
Protocol T randomized eyes with center-involving DME to bevacizumab, ranibizumab or aflibercept. At 1 year, aflibercept was superior to both other agents in eyes with baseline visual acuity of 20/50 or worse, while all three performed similarly when baseline acuity was 20/32 or better. This stratified result is the single most examined fact from Protocol T. Triamcinolone was not part of the main three-arm comparison and carries a higher cataract and glaucoma burden.
Reference: Ryan's Retina, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.