Abstract
Purpose:
Ranibizumab Intravitreal injections (IVT) improve Best Corrected Visual Acuity (BCVA) and lower Central Foveal Thickness (CFT) in Diabetic Macular Edema (DME). This treatment requires a monthly follow-up. Nevertheless, a long period of follow-up interruption can occur during summer break. The purpose of this study was to evaluate whether this period actually impacts on BCVA and CFT over the course of DME treatment.
Methods:
We included in a retrospective fashion all patients with DME over the course of Ranibizumab injections from April to October 2013 with good anatomical and functional results after 3 initial IVT followed by a pro re nata strategy. We have included all patients who were neither followed nor injected during at least 7 consecutive weeks. 2 outcomes were assessed : BCVA (ETDRS scale) and CFT on spectral domain OCT, (OPKO, Optos, Dunfermline, Scotland) before and after the break.
Results:
We have included 12 eyes of 11 patients (6 women, 5 men) who stopped their follow-up for at least 7 weeks. Mean age was 61.8 years, mean duration of break was 12 weeks (from 7.1 to 26 weeks). Patients underwent an average of 4 IVT and were treated for 5.7 months before the summer break. All patients came back to follow-up after the break. When the patients were back to follow-up, mean decrease in BCVA was -3.6 letters (from +8 to -22 letters) and mean increase in CFT was +209 microns (from -200µm to +920 µm).
Conclusions:
3 months of break in follow-up generally due to summer holiday, does not seem to have irreversible consequences on functional results in DME treatment. In this case series, the break of follow-up has widely increased CFT while it did not significantly impact BCVA. This fact underlines the weak correlation between anatomical and functional results over the course of DME treatment.
Keywords: 499 diabetic retinopathy •
505 edema