Rapid Improvements In DME With Next-Generation Anti-VEGF Therapies: Case Highlights

EP: 1.Improved Retinal Drying and Treatment Durability In nAMD With Aflibercept 8 mg

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EP: 2.Rapid Improvements In DME With Next-Generation Anti-VEGF Therapies: Case Highlights

The second episode transitions to diabetic macular edema (DME) treatment using next-generation anti-VEGF agents. Dr. Dhoot presented a case with large cystoid changes and intraretinal fluid that showed progressive improvement after aflibercept 8 mg treatment. Although the initial response after the first injection wasn’t dramatic, continued improvement was observed with subsequent treatments, highlighting the importance of patience when evaluating treatment efficacy.

Another DME case demonstrated limited response to aflibercept 2 mg but showed significant anatomical improvement and vision enhancement from 20/60 to 20/25 after switching to aflibercept 8 mg. The panel noted that the higher molar dose (4x) of aflibercept 8 mg appeared to produce consistently better anatomic responses in DME patients, a finding commonly observed across their practices. This reinforces the value of higher-dose anti-VEGF options for patients with suboptimal responses to standard dosing.

Dr Dhoot shared a personal case of a 72-year-old man with DME who initially received a ranibizumab biosimilar with limited durability, requiring monthly dosing. After switching to faricimab, the patient showed dramatic improvement with treatment intervals successfully extended to 9 weeks. The case illustrated the importance of finding each patient’s “sweet spot” for treatment intervals, as attempts to extend beyond 9 to 10 weeks resulted in fluid recurrence. In summary, newer-generation anti-VEGF agents provide improved drying efficacy and typically allow 2- to 3-week treatment extensions, significantly reducing treatment burden while improving outcomes.