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Sachi Abe, Sakiko Goto, Katsuhiro Nishi, Teiko Yamamoto, Hidetoshi Yamashita; Effects of second-line intravitreal anti-VEGF therapy for refractory diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2069.
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© ARVO (1962-2015); The Authors (2016-present)
There are several treatment modalities to treat diabetic macular edema (DME), which have been applied to DME patients in the real world. According to DRCR net, the topical steroid therapy has certain effects on DME especially in patients with pseudophacia, so we have used the topical steroid therapy as the first-line treatment. In these situations, it is mandatory to change the treatment modalities in the refractory DME. The aim of this study is to investigate the effects of intravitreal injection of ranibizumab 0.5mg（IVR） as the second-line treatment in persistent DME even after the topical steroid therapy.
This study was a retrospective non-randomized study, approved by the Ethics Committee of Yamagata University School of Medicine.[UMIN 000001432] This study included persistent DME patients with poor effects of topical steroid therapy, and/or those with the intolerable increase of intraocular pressure after steroid therapy. The subjects were examined every month and treated by IVR with Pro Re Nata regimen. Main outcome measures were best-corrected visual acuity（BCVA）shown by logMAR and central macular thickness（CRT） and complications which were investigated at every monthly visit.
Thirty-three eyes of 24subjects were included this study (10 male and 14 female subjects). At the baseline the mean BCVA was 0.577±0.40,and the mean CRT was 548.1±158.9μm. The mean duration of observation was 4.9 months and the mean number of IVR applidacion was 2.1 after the treatment changes. The mean BCVA was significantly improved to 0.429±0.34（p=0.004） after 1month, and was to 0.38±0.33（p=0.043）after 3months. The mean CRT decreased significantly to 426.9±125.1（p<0.01） after 1 month, to 453.6±165.2（p=0.015） after 3 months. No remarkable complications were detected.
Intravitreal injections of ranibizumab was effective as the second-line treatment modality even in the eyes with persistent diabetic macular edema after steroid therapy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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