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T. M. Dzhusoev, Jr., Y. Bayborodov; Comparison of the Efficacy of Intravitreally Injected Ranibizumab versus Retinal Internal Limiting Membrane (ilm) Removal in Diabetic Maculopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5074.
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To compare the clinical outcomes of the intravitreal injections of ranibizumab (Lucentis) with surgical removal of retinal ILM in patients with diabetic macular edema (DME).
This study included 112 patients (140 eyes), aged between 52 and 75 years, diagnosed with clinically significant DME. Patients were divided into two groups: group I (95 eyes) received three intravitreal injections of 0.5 µg ranibizumab, with one-month intervals; group II (45 eyes) underwent 25-guage vitrectomy with posterior hyaloid and ILM peeling. All patients underwent standard diagnostic procedures including best-corrected visual acuity (BCVA) measurements, ophthalmoscopy, fundus photography, and optical coherent tomography (OCT) with retinal thickness (RT) measurements. Patients were examined within one week prior to treatment and at one and three months after treatment. Statistical comparison of pre- to post-treatment BCVA and RT measurements was performed for each group, and post-treatment values were compared between groups.
Patients of the group I showed no complications during the entire follow-up period. In group II, at 3-month time point, 4 eyes had pericentral scotomas, 2 eyes developed macular hole, and 1 eye developed optic nerve disk atrophy. RT decreased by 22.5±6.7% in group I (p=0.2), and by 46.8±16.2% in group II (p<0.01).
1) Intravitreal ranibizumab did not cause complications in short-term follow-up period; the outcomes are comparable to 25-G vitrectomy with ILM peeling. 2) In spite of the pronounced anatomical improve, vitrectomy with ILM peeling did not produce better functional response, as compared to ranibizumab.
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