Abstract
Purpose:
To study symmetry of anatomic and functional response in bilateral diabetic macular edema (DME) treated by bilateral intra vitreal injection of ranibizumab (IVR).
Methods:
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.
Results:
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.
Conclusions:
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.
Keywords: 499 diabetic retinopathy •
688 retina •
505 edema