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Johannes Schiefelbein, Christoph Kern, Michael Müller, Diana Jeliazkova, Maximilian Weiß, Siegfried Priglinger, Karsten Ulrich Kortuem; Real life gender related differences in patients with diabetic macular edema treated with ranibizumab. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1914.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to investigate differences between men and women in the treatment of diabetic macular edema (DME) with intravitreal injections of ranibizumab. For this analysis we queried our data warehouse containing clinical records of around 350,000 patients for retrospective data.
78 patients with 104 eyes with center-involving DME were treated with intravitreal ranibizumab in our institution between Feb-11 and Mar-15. Patients were reviewed over a follow-up period of at least 320 days. 62.5% of patients (n=65) were male (61.9 years) and 37.5% (n=39) female (63.1 years).All patients received at least 3 injections of 0.5 mg ranibizumab. To evaluate the therapeutical effect we analyzed the SD-OCT volume scans (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany) and measured the visual acuity (VA) before and during the treatment. For evaluation, we used correlation analysis and Mann-Whitney-U-Test.
The mean VA and central retinal thickness (CRT) at baseline were 0.481 (± 0.269) logMar (male: 0.416, female: 0.590) and 454.33 (± 153.89) μm (male 426.92 μm, female: 500.00 μm). The average number of injections was 5.11 (± 1.57) (male: 5.00, female: 5.28) during the period of 320 days, there was no significant gender differences.On average, after 320 days the VA changed by -0.095 (± 0.174) logMar, while the CRT changed by -122.60 (± 142.38) μm. The Mann-Whitney-U-Test showed a significant difference in the baseline VA (U=743.00, p=0.00) and CRT (U=925.50, p=0.022) between men and women. In addition, the mean VA after 320 days of treatment differed significantly between these two groups (U=675.00, p=0.00). In contrast, the mean CRT after 320 days of treatment and the mean change in VA and CRT did not show any significant differences between these two groups.
The overall results in our institution are comparable with outcomes from other clinical trials.The significantly worse average baseline VA and CRT, as well as the VA between men and women after 320 days of treatment, show the importance of early DME treatment before patients experience a serious vision loss.Furthermore, the results raise the question if women developing DME should be examined and treated in closer intervals.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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