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Christian Pruente, Katja Hatz; Ranibizumab Treatment for Diabetic Macular Edema in a Clinical Routine Setting: 12 Months Results. Invest. Ophthalmol. Vis. Sci. 2011;52(14):563.
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To evaluate the efficacy of ranibizumab treatment in diabetic macular edema (DME) in a routine clinical setting and correlations of baseline characteristics, Spectral(SD)-OCT and visual acuity outcomes.
Data of 30 eyes with visual impairment due to DME with a follow-up of 12 months were analyzed. All eyes were treated following a PRN regimen. Baseline characteristics, OCT results for central retinal thickness (CRT) and volume and best corrected visual acuity (BCVA) results were correlated. Absolute values and a logarithmic transformation of excess CRT were used for calculations. All calculations were performed for 3-, 6-, 9- and 12-months outcomes.
Mean values at baseline were 473µm for CRT, 8.85 mm3 for macular volume, and 0.46 for LogMAR visual acuity. During the follow-up period of 12 months a mean number of 3.9 ranibizumab injections were given, almost half of these from baseline to month 3 (1.93). CRT significantly (p<0.01) decreased by 68, 73, 85 and 85µm at months 3, 6, 9, and 12. Visual acuity significantly (p<0.01) improved to 0.31, 0.33, 0.29 and 0.30 LogMAR respectively. Greater improvement of BCVA occurred in eyes with shorter duration of macular edema and better baseline visual acuity (≤ 0.4LogMAR). No correlation was found between BCVA change and the absolute change in CRT or macular volume. However a significant correlation (p<0.05) was found between BCVA and the change in CRT based on the logarithmic calculation. No correlation of BCVA could be found with baseline CRT, baseline macular volume, pre-treatments (focal laser coagulation, intravitreal triamcinolone) or the frequency of ranibizumab injections.
These results suggest that repeated intravitreal injections of ranibizumab can significantly reduce central retinal thickness and improve visual acuity in patients with DME in a clinical routine PRN regimen with a mean of 3.9 injections. Eyes with shorter history of visual impairment and better baseline BCVA seem to show better BCVA improvement. Interesting is the fact that a significant correlation was found between BCVA and excess CRT if calculated in a logarithmic transformation like LogMAR is calculated.
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