Purpose
To evaluate long-term functional and anatomical outcomes of intravitreal injection of Ranibizumab to treat diabetic macular edema (DME) in clinical practice.
Methods
A retrospective monocentric study was performed on patients treated for DME by intravitreal injections of Ranibizumab between 2011 and 2014, with a follow up of at least 18 months. Data collected included baseline demographics (history of the diabetes, hemoglobin A1c level…) and ocular findings (initial and final visual acuity (VA), indirect biomicroscopy examination, retinal photographs, central macular thickness (CMT) on optical coherence tomography). Main outcome measures were mean change in VA and CMT at 18 and 24 months. Secondary outcome measures were number of injections during the follow-up and percentage of eyes in remission, defined by the absence of injection during the last 5 months of follow up with VA stability.
Results
Sixty eight (68) eyes of 49 patients were included. Mean duration of follow-up was 25,2 ± 6,1 months [range 18 - 40,6 months]. Mean initial VA letter score was 53,9 ± 15,7 [1 - 83] (snellen equivalent 20/80) and mean initial CMT was 533,9 ± 147,1 μm [279 - 987 μm]. Mean change in VA letter score was +8,5 ± 11,4 [-26 - +35 ETDRS] at month 18 and +9,4 ±11,3 [-14 - +34] at month 24. The mean change in CMT at month 18 and 24 was respectively -141,7 ± 144 µm [-672 - +239 µm] and -152,8 ± 153 [-671 - +163 µm]. The mean of number of intravitreal injections was 7,1 ± 1,3 (median = 7) from baseline to month 12 ; 2,4 ± 1,6 (median = 3) from months 12 to 18, and 1,8 ± 1,6 (median = 2) from months 18 to 24. At month 18, 19,1% of eyes (13/68 eyes) were considered in remission.<br />
Conclusions
Ranibizumab was effective in maintaining VA and CMT outcomes at month 18 and 24 in patients with DME in clinical practice, with a declining number of injections, confirming the results of randomized clinical trials.