According to the DRCR Protocol T results at 1 year, which statement regarding treatment of center-involved diabetic macular edema is correct?

• A Bevacizumab produced the greatest visual gain across all baseline acuities
• B The three agents were identical regardless of presenting visual acuity
• C Ranibizumab outperformed aflibercept only in eyes with good baseline acuity
• D Aflibercept produced greater visual improvement than bevacizumab and ranibizumab in eyes with baseline acuity of 20/50 or worse ✓

Explanation

Protocol T randomized eyes to aflibercept, bevacizumab, or ranibizumab. Overall, aflibercept was modestly superior, but the effect was driven by the subgroup with baseline visual acuity of 20/50 to 20/320, in whom aflibercept gave significantly greater gains at 1 year than either comparator. In eyes with better baseline acuity (roughly 20/32 to 20/40), all three agents performed similarly, which is the fact that kills the uniformity-based distractors.

Reference: American Academy of Ophthalmology Basic and Clinical Science Course, Section 12, Retina/Vitreous, recent edition ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.