Impact of Ranibizumab on visual impairment among patients with bilateral diabetic macular oedema

Abstract

Purpose : In case of bilateral retinal disease, there is a strong relationship between visual impairment and visual acuity on the better eye. Diabetic macular edema (DME) is often a bilateral disease. The purpose of this study was to assess the impact of intravitreal injections (IVT) of Ranibizumab on visual impairment among patients with simultaneous visual acuity loss due to DME.

Methods : We performed a retrospective study including all patients with DME and visual loss treated with ranibizumab since November 2011 and with a minimum follow up of 6 months. Patients were recruited in two sites (Hôpital Avicenne, Bobigny and Centre d’Imagerie et de Laser, Paris). Patients selected in this study were those who exhibited a simultaneous visual decrease on both eyes. The simultaneous decrease was defined as visual loss that requires IVT of ranibizumab with less than 6 month interval between the right eye and the left eye. Visual impairment was defined as visual acuity less than 20/40 in the better eye. A 6 month follow-up was performed.

Results : 138 patients were treated with ranibizumab. Among these patients 35.5% (49 patients) underwent bilateral IVT. In 63.2% of cases (31 patients) IVT were performed with an interval of less than six months between the first and the second affected eye. At baseline 83.9% of patients had a visual acuity of their better eye < 20/40. At the end of the follow-up 51.6% of patients had a visual acuity of their better eye < 20/40, i.e a reduction of 38.4% of visual impairment. On the better eye, mean visual acuity (VA) at baseline was 57.86 ETDRS letters, 68,51 letters at month 3 and 66 letters at month 6, i.e a +8.68 letters VA gain. Mean VA difference between both eyes was 13.64 letters. On the worse eye, mean baseline VA was at 44.22 letters, 55.69 letters at month 3 and 53.18 letters at month 6, a mean VA gain of +8.96 letters.

Conclusions : Among patients with bilateral simultaneous occurrence of DME, intravitreal injections of ranibizumab reduce the frequency of visual impairment.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.