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Margaux Guillard, Ali Erginay, Bénédicte Dupas, Ramin Tadayoni, Pascale G Massin; Symmetry of anatomic and functional response in bilateral diabetic macular edema treated with ranibizumab. Invest. Ophthalmol. Vis. Sci. 2014;55(13):608.
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© ARVO (1962-2015); The Authors (2016-present)
To study symmetry of anatomic and functional response in bilateral diabetic macular edema (DME) treated by bilateral intra vitreal injection of ranibizumab (IVR).
36 eyes from 18 patients treated with bilateral IVR were retrospectively reviewed. All patients received at least 3 monthly IVR injections over a five-months period. Favorable anatomic response was defined as a reduction of more than 10% of baseline central macular thickness (CMT) and favorable functional response was defined as an increase of best-corrected visual acuity (BCVA) of 5 letters or more on the ETDRS scale.
A symmetric favorable anatomic response was observed in 16 (89%) patients, with an associated symmetric favorable functional response in 13 (72%) patients (i.e bilateral BCVA gain ≥ 5 letters of more). In the 3 remaining patients (17%), an asymmetric functional response was observed, i.e BCVA gain ≥ 5 letters was obtained in only one eye. An asymmetric anatomic response was seen in 2 (11%) patients. In the first case, no favorable functional response was observed in both eyes. Asymmetric anatomic response was explained by a local factor (lack of decrease in CMT in the eye with epiretinal membrane). In the second case, a favorable functional response was observed in the eye with favorable anatomic response, and poor anatomic and functional responses were observed in the fellow eye. Eye without anatomic response had a history of vitrectomy.
Anatomic response was symmetric in 89% of patients treated by bilateral IVR for bilateral macular edema, and symmetric favorable functional response was observed in 72% of cases. This may be of clinical interest in the decision to treat the fellow eye, in a disease where bilateral involvement is frequent.
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