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Susan B. Bressler, Haijing Qin, Diabetic Retinopathy Clinical Research Network; Factors Associated With Changes In Visual Acuity And Oct Outcomes One Year After Ranibizumab Treatment For Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5329.
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To identify factors associated with changes in visual acuity (VA) and OCT central subfield (CSF) thickness at 1 year following ranibizumab treatment with immediate or deferred focal/grid laser in eyes with center involved diabetic macular edema (DME).
Because 1-year outcomes were similar in the 361 eyes in the two ranibizumab arms of the recently completed clinical trial assessing various treatments for DME they were pooled for this analysis. Regression models were used to evaluate 38 baseline demographic, systemic, ocular, OCT, and fundus photographic variables for association with visual acuity/OCT improvement from baseline to 1 year. Separately, evolution of CSF measurements relative to baseline at months 4, 8, and 12 were also evaluated for effect on VA at 1 year, adjusting for baseline risk factors.
Baseline VA was the only consistent predictor of 1-year VA outcomes (P<0.001) and baseline CSF thickness was the only consistent predictor of 1-year CSF thickness outcomes (P<0.001) [Table1]. These results may be due to ceiling and floor effects of these variables. We found no other clinically relevant baseline variables that would predict VA or OCT outcome in ranibizumab-treated patients with DME. CSF improvement over follow-up was associated with the 1-year VA outcome (P<0.001).
Other than VA and OCT values, baseline variables were not helpful as outcome predictors of ranibizumab treatment. Lower levels of baseline VA and early and consistent anatomic improvement throughout the 1st year of treatment are factors associated with vision improvement; CSF thickness change is associated with baseline CSF.
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