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L. A. Marzette, J. Gloth, P. Beer; High Dose Ranibizumab in the Treatment of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4252.
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To evaluate the safety and tolerability of 1 mg monthly intravitreal injections of ranibizumab in the treatment of diabetic macular edema (DME).
We retrospectively reviewed the records of 8 eyes (6 patients) who received three monthly intravitreal injections of 1 mg ranibizumab for the treatment of DME after failing standard care. Central foveal thickness, measured using optical coherence tomography (OCT), and Snellen visual acuity were the main outcome measures used to evaluate the efficacy of therapy. The mean length of follow up was 112 days.
The mean decrease in central foveal thickness was -103 microns. The range of change in central foveal thickness was +137 (increase in central foveal thickness) to -325 microns (a decrease in central foveal thickness). The mean change in visual acuity improved from a pre-injection Snellen visual acuity of 20/100 to a post-injection visual acuity of 20/80. The mean post-injection visual acuity in patients who received all three injections (includes five cases) was 20/60. In patients who only received one or two injections (includes three cases), the mean post-injection visual acuity was 20/100. Thus patients who completed the series of three injections had greater improvements in visual acuity than their counterparts who only had one or two injections. There were no ocular or systemic adverse events.
One mg intravitreal ranibizumab monthly injections were well tolerated in our small cohort of patients with diabetic macular edema over a short period of time. This dosage of ranibizumab appeared to have a beneficial effect on visual acuity and reduction of central retinal thickness.
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