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Purpose: To compare the visual and anatomic outcomes of intravitreal ranibizumab versus aflibercept in patients with diabetic macular edema (DME) in a real-world study.Methods: This is a single-center retrospective comparative study of treatment-naïve patients who received intravitreal ranibizumab or aflibercept administration for DME for at least 12 months on an as needed regimen following three-monthly loading doses. The primary outcomes of the study were the mean change in best-corrected visual acuity (BCVA), central macular thickness (CMT), central macular volume (CMV). Factors to potentially affect these parameters were also analyzed.Results: A total of 100 eyes (66 patients) were included in the study. Fifty two eyes received ranibizumab and 48 received aflibercept injections. While the decrease in mean CMT at the 4th-month visit was significantly higher in the aflibercept-treated group than in the ranibizumab-treated group (p=0.02), there was no difference between the two groups at the end of the one-year follow-up (p=0.25). There was no significant difference between the two groups in terms of change in mean CMV during the follow-up. (p=0.26, p=0.27 at 4 and 12 months, respectively). The mean number of injections were also similar between groups (4.5 ± 1 vs. 4.6 ± 1.1 respectively, p=0.63).Conclusion: In a real-world setting, ranibizumab and aflibercept were both found to be effective in the first-line treatment of DME. Patients with DME who received fewer injections in the real-world could achieve visual and anatomical results comparable to randomized controlled trials participants.

Background: To analyze the microvascular parameters using optical coherence tomography angiography (OCTA) in non-infectious posterior uveitis (PU) patients. Methods: In this cross-sectional study, OCTA images of patients with non-infectious PU were evaluated. The vessel densities (VD) in the superficial and deep capillary plexuses (SCP & DCP), foveal avascular zone (FAZ) area were measured and compared to healthy controls. Results: The study cohort comprised 64 patients with age and gender-matched groups. The VD in the SCP was 43.9±3.9% in the whole image; 18.4±4.8% in the fovea, 43.9±4.6% in the parafoveal area, and 43.4±9.7% in the perifoveal zone, in eyes with uveitis. These were respectively 48.8±2.9%, 22.9±6.9%, 50.9±3.0%, and 49.2±3.1% in the control group (p=0.0001, 0.043, 0.0001, 0.01, respectively). The changes in the DCP in eyes with uveitis were not significant. In the uveitis group, the FAZ was significantly enlarged compared to controls (0.37±0.1 microns vs. 0.24±0.2 microns, p=0.046). Conclusion: OCTA depicted significant changes including decreased VD in the SCP and enlarged FAZ in non-infectious PU.