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Tomoaki Murakami, Keiichi Nishikawa, Akihito Uji, Yoko Dodo, Noriko Terada, Nao Aisu, Akitaka Tsujikawa; Factors Predicting Treatment Frequency of Ranibizumab Injections during the Second Year in Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1067.
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Anti-VEGF therapy is the first-line for diabetic macular edema (DME), although its socioeconomic burden is a serious concern. We therefore investigate the predictors of the treatment frequency in the second year under as-needed intravitreal ranibizumab (IVR) injections for DME.
In this retrospective study, we reviewed 65 eyes of 60 patients with center-involved DME who received pro re nata (PRN) IVR injections following three monthly loading doses. The central subfield thickness (CST) and qualitative findings were assessed on spectral domain optical coherence tomography (SD-OCT) images. We then investigated whether parameters at baseline or 12-month visit were associated with the treatment frequency in the second year.
The number of ranibizumab injections decreased from 6 (4-8) during the first year to 2 (0-3) during the second year (P<0.001), despite the maintenance of functional efficacy from 12- to 24-month visits. The injection numbers during the first year (ρ=0.259, P=0.037) but not during the second year (ρ=0.152, P=0.226) were modestly related to logarithm of the minimum angle of resolution (logMAR) improvement at 24 months. Multivariate analyses revealed that CST and hyperreflective walls in foveal cystoid spaces at baseline were associated with the number of IVR injections during the second year (β=0.363, P=0.003 and β=0.234, P=0.048, respectively). The treatment frequency during the second year was also related with CST (β=0.266, P=0.012), hyperreflective walls (β=0.394, P=0.002), and the cumulative doses of ranibizumab injections (β=0.294, P=0.006) at 12-month visit.
CST and hyperreflective walls in foveal cystoid spaces are designated as predictors of treatment frequency of ranibizumab injections during the second year in DME.
This is a 2021 ARVO Annual Meeting abstract.
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