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Yoshito Koyanagi, Shigeo Yoshida, Yoshiyuki Kobayashi, Yuki Kubo, Muneo Yamaguchi, Takahito Nakama, Shintaro Nakao, Yuji Oshima, Tatsuro Ishibashi, Koh-hei Sonoda; Intravitreal ranibizumab for diabetic macular edema in vitrectomized versus nonvitrectomized eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2074. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There remains limited evidence regarding the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) treatment on diabetic macular edema (DME) after vitrectomy. The purpose of this study was to compare the effectiveness of intravitreal ranibizumab (IVR) for DME in vitrectomized versus nonvitrectomized eyes.
We prospectively evaluated data from the baseline through the 6-month visits for 25 eyes of 20 patients who underwent IVR for DME between February 2014 and April 2015 at Kyushu University Hospital. Ten eyes were vitrectomized at least 3 months before IVR treatments and 15 eyes were nonvitrectomized. The inclusion criteria were best-corrected visual acuity (BCVA) less than 0.7 (decimal notation) and/or central macular thickness (CMT) greater than 350 μm measured by optical coherence tomography. Paired t-test and Student’s t-test were used for statistical analysis. The Institutional Ethical Committee of Kyushu University Hospital approved the present study.
At baseline, there were no significant differences between both groups with respect to age, sex, glycemic control, logMAR BCVA, CMT, or number of injections. The mean changes in logMAR BCVA and CMT were both significant at 6 months compared to baseline (-0.10 ± 0.04: p<0.05, and -165 ± 41 μm: p<0.01, respectively) when the nonvitrectomized and vitrectomized groups were combined. The mean change in logMAR BCVA was significant in the nonvitrectomized groups (-0.15 ± 0.05, p<0.01), and was not significant in the vitrectomized groups (-0.04 ± 0.06, p=0.5). In contrast, the mean CMT change was significant both in the nonvitrectomized groups (-152 ± 43 μm, p<0.01) and in the vitrectomized groups (-185 ± 82 μm, p<0.05). At the 6-month visit, 73% and 40% of the eyes had greater than 0.1 reductions from baseline in logMAR BCVA in the nonvitrectomized and vitrectomized groups, respectively. There were not significant differences between both groups in the mean change of BCVA and CMT.
These results indicate that IVR may be an important treatment option for vitrectomized DME eyes, although the improvement appeared slower in vitrectomized eyes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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