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Purpose: To evaluate the efficacy of switching to aflibercept in diabetic macular edema (DME) with suboptimalresponse to previous anti-vascular endothelial growth factor (anti-VEGF) injections. Methods: A prospective interventional case series study recruited patients from a single center diagnosedwith DME with suboptimal response to anti-VEGF injections. Three consecutive monthly injections of afliberceptwere performed. The primary outcome measure was mean change in visual acuity after switching toaflibercept. Results: Forty-two patients (42 eyes) were included. Baseline logarithm of the minimum angle of resolution(logMAR) visual acuity was 0.87 ± 0.23 and improved significantly to 0.62 ± 0.29, 0.56 ± 0.34, and 0.46 ±0.35 at 1, 2, and 3 months, respectively, after the first injection. Mean baseline retinal thickness was 451.57± 107.09 μm and decreased significantly at 1, 2, and 3 months after switching to aflibercept (346.52 ± 79.03,328.24 ± 81.98, and 313.71 ± 85.79 μm, respectively). Both visual improvement and mean change in retinalthickness were significant in patients with pre-aflibercept best-corrected visual acuity less than 1.0 logMARbut were not significant in patients with best-corrected visual acuity more than 1.0 logMAR. Conclusions: Switching to aflibercept in DME patients with an unsatisfactory response to previous anti-VEGFinjections provided acceptable short-term visual and retinal architectural improvement.

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