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Angela Rees, Habib Abubakar, Ranjan Rajendram, Sheelah Antao, Namritha Patrao, Razia Amin, Zaid Shalchi; Is HbA1c a predictor of response to ranibizumab therapy in diabetic macular edema?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2112.
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© ARVO (1962-2015); The Authors (2016-present)
Ranibizumab has transformed the treatment of diabetic macular edema but little is known about how systemic glycaemic control affects treatment outcome. We wanted to investigate the effect of glycated haemoglobin (HbA1c) on the efficacy of ranibizumab in the treatment of diabetic macular edema using a retrospective clinical case series.
The Moorfields OpenEyes and diabetes nursing databases were used to study eyes with diabetic macular edema treated with ranibizumab from October 2013 to November 2015 at the main City Road site. Only eyes receiving at least 3 injections and completing 12 months follow-up were included. Where both eyes received treatment, the first treated eye was included for analysis. When both eyes received initial treatment simultaneously, random number tables were used to select the eye for analysis. The primary outcome was number of injections in year 1. The secondary outcome was gain in visual acuity ETDRS letters. Good glycaemic control was defined as HbA1c ≤ 59 mmol/mol (7.5%), with poor control above this figure.
One hundred and nineteen eyes were included in the analysis. 62 (52.0%) eyes were in patients with poor glycaemic control. The mean±SD number of injections in year 1 was similar in both the good and poor control groups (6.66±3.51 vs 6.63±3.61, p=0.95). The gain in ETDRS letters was also similar in both low and high HbA1c groups (5.00±7.39 vs 8.06±15.23, p=0.16).
HbA1c is not a predictor of outcome in eyes with diabetic macular edema receiving ranibizumab therapy.
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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