Real-life experience of ranibizumab for diabetic macular edema in Taiwan

• Published in: International ophthalmology 2019-07, Vol.39 (7), p.1511-1522
• Main Authors: Tsai, Meng-Ju, Hsieh, Yi-Ting, Peng, Yi-Jie
• Format: Article
• Language: English
• Subjects: Acuity; Diabetes; Diabetes mellitus; Diabetic retinopathy; Edema; Eye; Eye (anatomy); Health care; Immunotherapy; Injection; Lasers; Medicine; Medicine & Public Health; Monoclonal antibodies; Ophthalmology; Original Paper; Patients; Retinopathy; Triamcinolone acetonide; Vision; Visual acuity
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-018-0970-7

Purpose To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan. Methods A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseline vision between 20 and 70 ETDRS letters and a minimum central macular thickness (CMT) of 300 µm, had at least 3 monthly loading injections of ranibizumab in a year. Macular laser or posterior subtenon injections of triamcinolone acetonide (PSTA) could be performed as supplementary treatments following loading injections. Primary outcomes include best-corrected visual acuity and CMT. Results Patients’ vision improved from 46.5 ± 15.3 letters at baseline to 51.4 ± 16.6 letters at 12 months ( p  = 0.031). Mean CMT at baseline was 406 ± 105 µm, which decreased to 329 ± 108 µm ( p  = 0.002). At 12 months, 44.4% of eyes with total injection number  0.05). The average number of injections was 4.3 ± 1.0. Conclusion Treatment for DME with at least three monthly ranibizumab loading injections, with or without other supplementary treatments, is effective at 12 months thereafter. Two monthly reinjections of ranibizumab, while not significantly increasing vision, may have a role in preventing visual loss.