Effect of a Single Intravitreal Ranibizumab Injection on Diabetic Macular Edema in Patients Who Discontinued Treatment

Yıl 2016, , 190 - 194, 16.06.2016

Erhan Yumusak

https://doi.org/10.5799/ahinjs.01.2016.02.0595

Öz

Objective: To evaluate the effect of a single dose of ranibizumab in patients with diabetic macular edema who discon­tinued treatment.

Methods: One eye of 85 patients with diabetic macular
edema who discontinued treatment after a single injection of ranibizumab
was studied. Best corrected visual acuity (BCVA), intraocular pressure
(IOP), central macular thickness (CMT), and optical coherence tomography
imaging were evaluated retrospectively. Changes in BCVA, IOP, CMT, and
their correlations with the follow-up period were statistically
analyzed.

Results: At baseline, the mean BCVA was 0.26 ± 0.20
(Snellen equivalent [SE]) and CMT was 469.04 ± 144.6 μm. After a mean
period of 6.12 ± 2.46 months, mean BCVA was 0.316 ± 0.23 SE and CMT was
403.07± 139.7 μm. There was a statistically significant increase in BCVA
and decreased in CMT (p= 0.02, p< 0.01, respectively), whereas mean
IOP values did not significantly change (p=0.24). There was no
statistically significant correlation between the follow-up duration and
BCVA or CMT (p=0.928 and p=0.992, respectively).

Conclusions: Visual outcome and CMT thickness were still superior to those before treatment even after a single ranibi­zumab injection. J Clin Exp Invest 2016; 7 (2): 190-194

Anahtar Kelimeler

Diabetic macular edema, ranibizumab, single dose.

Kaynakça

• 1. Davidson, J. K. Clinical diabetes mellitus, diabetic eye dis - ease. Thime Medical Publishers 1991;427-444. 2. Murakami T. Yoshimura N. Structural changes in individual retinal layers in diabetic macular edema. J Diabetes Res. 2013;920713. 3. Aiello, L.P. Angiogenic pathways in diabetic retinopathy. N Eng J Med. 2005;353:839-41. 4. Antonetti D.A., Barber A.J., Khin S. et al. Vascular permeabil - ity in experimental diabetes is associated with reduced en - dothelial occludin content: vascular endothelial growth fac - tor decreases occludin in retinal endothelial cells. PennState Retina Research Group. Diabetes. 1998;47:1953-9. 5. Nguyen QD, Shah SM, Khwaja AA, et al. READ-2 Study Group. Two-year outcomes of the ranibizumab for edema of the macula in diabetes (READ-2) study. Ophthalmology. 2010;117:2146-51. 6. Soheilian M., Ramezani A., Obudi A., et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology 2009;116:1142-50. 7. Ferrara N., Domico L., Shams N, et al. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age- related macular degeneration. Retina. 2006; 26:859-70. 8. Photocoagulation for diabetic macular edema. Early Treat - ment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985;103:1796-1806. Yumusak E, et al. Effect of Intravitreal Ranibizumab on Diabetic Macular Edema 194 J Clin Exp Invest www.jceionline.org Vol 7, No 2, June 2016 9. Yang JC, Haworth L, Sherry RM, et al. A randomized trial of bevacizumab, an anti-vascular endothelial growth fac - tor antibody, for metastatic renal cancer. N Engl J Med. 2003;349:427-34. 10. Marshall J. The role of bevacizumab as first-line therapy for colon cancer. Semin Oncol. 2005;32:S43-S47. 11. Michels S, Rosenfeld PJ, Puliafito CA, et al. Systemic bevacizumab (Avastin) therapy for neovascular age-re - lated macular degeneration: twelve-week results of an uncontrolled open-label clinical study. Ophthalmology. 2005;112:1035-47. 12. Rosenfeld PJ, Moshfeghi AA, Puliafito CA. Optical co - herence tomography findings after an intravitreal injec - tion of bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmic Surg Lasers Imaging. 2005;36:331-5. 13. Avery RL, Pieramici DJ, Rabena MD, et al. Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmology. 2006;113:363-72. 14. Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion. Ophthalmic Surg Lasers Imaging. 2005;36:336-9. 15. Massin P, Bandello F, Garweg JG, et al. Safety and ef - ficacy of ranibizumab in diabetic macular edema (RE - SOLVE Study): a 12-month, randomized, controlled, double-masked, multi- centerphase II study. Diabetes Care. 2010;33:2399-405. 16. Turkoglu EB, Celık E, Aksoy N, et al. Changes in vision related quality of life in patients with diabetic macular ede - ma: Ranibizumab or laser treatment? J Diabetes Complica - tions. 2015;29:540-43. 17. Brown DM, Nguyen QD, Marcus DM, et al. Long-term out - comes of ranibizumab therapy for diabetic macular edema: The 36-month results from two phase III trials: RISE and RIDE. Ophthalmology 2013;120:2013-2022. 18. Vaze A, Fraser-Bell S, Gillies M.anagha. Reasons for dis - continuation of intravitreal vascular endothelial growth fac - tor inhibitors in neovascular age-related macular degenera - tion. Retina. 2014; 34:1774-8. 19. Muether P., Droege K.M., Fause S. Vascular endothelial growth factor suppression times in patients with diabetic macular oedema treated with ranibizumab. Br J Ophthal - mol. 2014; 98:179-81. 20. Ikemori S, Kato A, Yasukawa T, et al. Effect of a single- dose regimen of intravitreal ranibizumab in the treatment of neovascular age-related macular degeneration. J Clin Exp Ophthalmol. 2012;3:221. 21. Han XX, Guo CM, Li Y, Hui YN. Effects of bevacizumab on the neovascular membrane of proliferative diabetic reti - nopathy: reduction of endothelial cells and expressions of VEGF and HIF-1α. Mol Vis. 2012;18:1-9 22. Yoon D, Rusu I, Barbazetto I. Reduced effect of anti-vas - cular endothelial growth factor agents on diabetics with vit - reomacular interface abnormalities. Int Ophthalmol. 2014; 34:817-23. 23. Elman M.J., Aiello L.P., Beck R.W. et al. Randomized trial evaluating ranibizumab plus prompt or deferred laser or tri - amcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2010;117:1064-77. 24. Selen F., Demirel S., Batıoglu F., Özmert E. Factors asso - ciated with visual acuity after treatment of diabetic macu - lar edema with intravitreal ranibizumab. Retina-Vitreus. 2013;21:269-73