PurposeTo evaluate the efficacy and safety of ranibizumab and aflibercept in the treatment of diabetic macular edema in a real world study, and to compare the two treatments with each other.MethodsRetrospective observational study of 213 eyes from 141 patients with diabetic macular edema was completed between June 2014 and June 2016. 122 were treated with ranibizumab intravitreal injection and 91 with aflibercept intravitreal injection, with a loading phase of 3 injections and a Pro Re Nata protocol. The drug was selected by the physician and fluorescein angiography was performed by physician`s criteria. Re-treatment was performed when a decline in BCVA, an increase of central macular thickness or an increase or persistence of intraretinal fluid in OCT was observed. The primary outcome was the mean change in best corrected visual acuity at 1 year, while central macular thickness, central macular volume, the number of injections and visits were evaluated as secondary outcomes. The correlation between BCVA at 4th month visit and BCVA at 12th month visit was also evaluated.ResultsThe mean baseline best corrected visual acuity for the eyes treated with ranibizumab was 0.55 (+/- 0.35) logMAR, and with aflibercept it was 0.48 (+/- 0.29) (P = 0.109). Best corrected visual acuity improved in both groups, and at the end of the follow-up was 0.40 (+/- 0.35) in the ranibizumab group and 0.40 (+/- 0.29) in the aflibercept group (P = 0.864). Best corrected visual acuity at 4th month visit is correlated at a high value (R = 0.789) with the one at the end of the study. No differences were found in central macular thickness, central macular volume and glycosylated hemoglobin when adjusting with baseline values. The overall number of injections was 5.77 (+/- 2.01), being 5.56 (+/- 2.0) in the ranibizumab group and 6.07 (+/- 1.99) in the aflibercept group (P = 0.069). The main outcome determining final best corrected visual acuity was the baseline best corrected visual acuity (P<0.001).ConclusionThere are no differences in efficacy between ranibizumab and aflibercept in diabetic macular edema treatment in this real world study.

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Purpose Evaluate the effect of extreme central corneal thickness in RNFL parameters measured by GDx VCC. Methods A total of 131 eyes of 131 subjects were included divided into 60 control and 71 glaucoma patients. All of the glaucoma eyes had reproducible defects on standard automated perimetry. Central corneal thickness was measured with an ultrasonic pachymeter. ROC curves were plotted in the sample subgroups with exteme pachimetry values (outside mean ± 2SD) and were compared with ROC curves of the subjects in the normal pachimetry range (mean ± 2SD). Results No differences were found in the areas under the ROC curve of the parameter of the GDx VCC in thinnest and thickest subgroups when compared with the mean pachymetry group. Conclusion Central corneal thickness has no influence in RNFL measurements of GDx VCC.

We evaluated the diagnostic ability of various diagnostic tools to detect glaucomatous damage in 101 normal eyes and 102 glaucomatous eyes. Mikelberg's linear discriminant function (LDF) obtained the best sensitivity followed by our own four formulas. With respect to specificity, Burk's LDF showed better results than Mikelberg's LDF and our formulae. Several Heidelberg retina tomograph analysis tools are useful to discriminate healthy from patients with glaucoma. Alternative tools based on normative databases derived from different autochthon populations add evidence needed to support their global use.