April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Evaluation of Fluorescein Angiograms in Eyes with Diabetic Macular Edema Treated with Ranibizumab over a 24-Month Period
Author Affiliations & Notes
  • Jang won Heo
    Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Jeong Hee Lee
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
    Ewha Womans University Hospital, Seoul, Republic of Korea
  • Yasir J. Sepah
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • R Channa
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Morgan Renner
    Georgetown University School of Medicine, Washington, Dist. of Columbia
  • Ahmed S. Fahmy
    Center for Informatics Science, Nile University, Cairo, Egypt
  • A Khwaja
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Zubir Rentiya
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Q D. Nguyen
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • D V. Do
    Retinal Imaging Research and Reading Center (RIRRC), Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
  • Footnotes
    Commercial Relationships  Jang won Heo, None; Jeong Hee Lee, None; Yasir J. Sepah, None; R. Channa, None; Morgan Renner, None; Ahmed S. Fahmy, None; A. Khwaja, None; Zubir Rentiya, None; Q. D. Nguyen, Regeneron, Genentech (F); D. V. Do, Regeneron, Genentech (F)
  • Footnotes
    Support  Juvenile Diabetes Research Foundation
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5330. doi:
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      Jang won Heo, Jeong Hee Lee, Yasir J. Sepah, R Channa, Morgan Renner, Ahmed S. Fahmy, A Khwaja, Zubir Rentiya, Q D. Nguyen, D V. Do; Evaluation of Fluorescein Angiograms in Eyes with Diabetic Macular Edema Treated with Ranibizumab over a 24-Month Period. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5330.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the changes in macular vasculature of eyes with diabetic macular edema (DME) treated with ranibizumab (RBZ).

Methods: : Fluorescein angiograms (FA) from patients in the Ranibizumab for Edema of the mAcula in Diabetes (READ-2 Study), a prospective randomized clinical trial, was systematically analyzed in the Reading Center (RIRRC) by 3 independent graders. The area graded was comprised of a 6-mm circular grid centered on the fovea. In the READ-2 study, 126 patients with DME were randomized (1:1:1) to receive 0.5 mg of RBZ (group 1), focal/grid laser photocoagulation (group 2), or a combination of RBZ and focal/grid laser (group 3). After month 6, the majority of subjects received monotherapy with RBZ. FA at baseline (BL) and month 24 were analyzed for 39 randomly selected subjects (13 eyes from each of groups 1, 2, and 3). Three variables were evaluated: areas of capillary non-perfusion, source and types [microaneurysms (MA) or diffuse] of leakage, and number of MAs contributing to leakage.

Results: : At month 24, the area of capillary non-perfusion did not change in any group when compared with BL. There was no change in the pattern of leakage in 83%, 55.6%, and 45.5% of eyes in groups 1, 2, and 3, respectively. The average number of leaking MAs decreased by 15.6% (group 1), 21.6% (group 2), and 9.2% (group 3). There was no statistically significant difference among the three groups in their longitudinal changes (BL to M24) based on the three defined variables (p=0.657, 0.332, 0.304).

Conclusions: : Analyses showed that vascular endothelial growth factor (VEGF) inhibition over 24 months with RBZ in eyes with DME did not result in increased capillary non-perfusion within the macula. In addition, RBZ injections appeared to decrease the number of leaking MAs. Further studies are needed in a larger study population to determine the effects of chronic VEGF suppression in eyes with DME.

Clinical Trial: : http://www.clinicaltrials.gov NCT00407381

Keywords: diabetic retinopathy • imaging/image analysis: clinical • vascular endothelial growth factor 
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