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Mohammad Sadiq, Muhammad Hassan, Yasir Sepah, Graeme Loh, Saleema Kherani, Mostafa Hanout, Rachel Annam, Mehreen Ansari, Diana Do, Quan Dong Nguyen, ; Effect of Statins and Diabetes Therapy (Oral Hypoglycemics and Insulin) on the Outcomes of Patients Treated with Ranibizumab and/or Laser Therapy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4027.
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To evaluate the role of concomitant use of statins, oral hypoglycemics or insulin, and the status of diabetic retinopathy, in determining the outcomes of patients with diabetic macular edema (DME) who were treated either with laser, ranibizumab (RBZ), or a combination of RBZ and laser.
Data from the READ-2 study was utilized for this study. For the purpose of analysis, data from the three study groups was combined and then stratified based on the severity of diabetic retinopathy (DR) and the use of statins, oral hypoglycemics, or insulin. Baseline characteristics were analyzed for each subgroup. The outcome variables assessed were mean change in BCVA (ETDRS scores) and foveal thickness. The effect of each parameter on the outcome variables was assessed using the Mann-Whitney U test. The number of RBZ injections given after month 6 (based on retreatment criteria) was also compared between patients receiving oral hypoglycemics and insulin therapy.
Baseline characteristics (age, race, gender, weight and hypertension) were found to be similar across all subgroups. No significant association was seen between the use of statins, insulin, or oral hypoglycemic agents on the outcome variables: foveal thickness and BCVA at month 6, 24, or 36 (P-values are shown in table 1). The severity of DR was also not associated with a significant change in the outcome. Mean number of injections required after month 6 were 5.51, 7.68, and 6.90 for patients on oral hypoglycemics alone, insulin alone, or a combination of both, respectively (p>0.05).
No significant association was detected between the use of concomitant medications such as statins, oral hypoglycemics, or insulin with the outcome of DME patients treated with RBZ, laser, or combination. Grade of DR was also not significantly associated with the outcome. Therefore, severity of DR and presence of co-morbidities should not affect treatment decisions for DME, as comparable visual benefits can still be achieved.
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