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Ahmadreza Moradi, Raafay Sophie, Rachel Annam, Owhofasa Agbedia, Hongting Liu, Mostafa Hanout, Millena Bittencourt, Mohamed Ibrahim, Diana Do, Quan Dong Nguyen; Retinal Vessel Caliber as a Predictor of Visual Outcome in Eyes with Diabetic Macular Edema (DME) Treated with Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):21.
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It has been reported that baseline venular caliber may be associated with visual outcomes in eyes with neovascular AMD treated with ranibizumab (RBZ) (Wickremasinghe et al. 2012). The index study aims to identify whether baseline retinal vessel caliber predicts visual outcome of patients with diabetic macular edema (DME) treated with RBZ.
The 1M field (as defined in the ETDRS study) of digital color fundus photographs of DME patients treated primarily with RBZ in a clinical trial were assessed. At baseline, the average retinal vascular caliber of the 6 largest venules (CRVE) and the 6 largest arterioles (CRAE) in the peripapillary area (0.5 and 1 disc diameter from the optic disc margin) was measured and analyzed using Interactive Vessel ANalysis (IVAN) software version 1.30 (Knudtson et al, 2003). The relationship of CRVE and CRAE at baseline to the change in visual acuity at months 12 was assessed using the Mann Whitney U test.
Twenty-five eyes which met all study criteria were analyzed. Ten eyes of 10 patients who had an improvement of ≥2 lines of best corrected visual acuity (BCVA) at months 12 had wider baseline CRVE (248.3±24.5µm) compared to 15 eyes of 15 patients who did not have an improvement of ≥2 lines (226.6±44.8µm, P<0.05). Baseline CRAE did not differ significantly in these patients (156.1±22.7 µm versus 142±17.5µm, p=0.17). Mean BCVA at baseline was 26.5 and 25.6 letters (those who gained ≥2 and < 2 lines, respectively). Systemic mean arterial pressures (MAPs) were also analyzed for all patients and were found to be balanced between the two groups.
A wider baseline retinal venular caliber may be a predictor of better visual outcome in DME patients treated with RBZ. Further prospective studies with a larger number of eyes are needed to confirm our findings.
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