Abstract
Purpose:
In Switzerland ranibizumab (Lucentis) is licensed for the treatment of diabetic macular edema (DME) since fall 2011. Prior to this an off label use of restricted number of injections was possible in individual cases, when the specific health insurance company confirmed refunding. Review of the visual acuity (VA) outcome in clinical setting.
Methods:
Retrospective analysis of VA in eyes with DME under ranibizumab treatment receiving at least one injection between April 2011 and April 2012. VA at baseline, month 3, 6, 12, 24 and at last visit were evaluated.
Results:
At baseline 125 eyes with DME and a mean VA of 68.8 ETDRS letters were treated with ranibizumab. 39 of them in an off label setting prior to approval by Swissmedic. Mean follow up was 24 month. 13 eyes had a change of therapy, 11 to triamcinolon and 2 to bevacizumab, whereat 7 of these were switched back to ranibizumab and 1 had a second change to bevacizumab. Mean number of injections was 6.17. Over the observed period the VA remained stable with a mean VA of 69.3 (M3), 70.4 (M6), 66.1 (M12) and 62.7 (M24) letters respectively in the follow up visits. At the last recorded visit mean VA was 70.2 letters. These results didn’t differ statistically. No statistical significant difference in VA was reached as well in respect to the number of injections, HbA1c, insulin dependence, diabetic retinal proliferations, central laser coagulation and time since diagnosis of diabetes.
Conclusions:
In this cohort of patients with DME treated with ranibizumab VA remained stable without a significant improvement. Limited visual acuity gain in this cohort is likely due to too infrequent treatment due to the prior off-label status of ranibizumab for DME.
Keywords: 498 diabetes •
688 retina •
754 visual acuity