Aflibercept in diabetic macular edema refractory to previous bevacizumab: outcomes and predictors of success

  • Dan Călugăru
  • Mihai CălugăruEmail author
Letter to the Editor

Dear Editor:

We would like to address several challenges that arise from the study by Laiginhas et al. [1].

The study was retrospectively conducted with a short follow-up.

There was a selection bias attributable to inclusion in the study of patients with all types of diabetic retinopathy (mild, moderate, and severe nonproliferative and proliferative diabetic retinopathy) as well as to pooling together of data from patients who were treated by different retina specialists [2]. Additionally, nothing was stated about the existence or otherwise of a washout period, which is essential between the two periods of treatments in terms of aliased effects. In the absence of a real washout period, the impact of the significant carryover effects of the bevacizumab (Avastin, Genentech, Inc., San Francisco, CA, USA) therapy may be confounded with direct effects of the aflibercept (Eylea, Regeneron, Tarrytown, NY, USA) treatment because these effects could not be estimated separately; therefore,...


Authors’ contribution

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Both authors (D.C and M.C) were involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

The authors have full control over the primary data and they agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review their data if requested.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyUniversity of Medicine Cluj-NapocaCluj-NapocaRomania

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