Abstract
Purpose To assess real-life efficacy of ranibizumab and treatment compliance of patients with vision loss secondary to diabetic macular edema (DME). Methods A retrospective study was conducted in DME patients treated with ranibizumab. Patients were monitored every 4 weeks for visual acuity (VA) and central retinal thickness (CRT) by SD-OCT. All patients received a loading dose of 3 monthly injections followed by retreatments on an as-needed basis. The primary endpoint was the change in VA at M12. Patient compliance to the follow-up and the correlation between the injection number and VA were also investigated. Compliance was compared to that of neovascular age-related macular degeneration (nAMD) patients. Results Seventy-two eyes of 55 consecutive DME patients were included. At baseline, the mean VA was 56.5 letters and CRT was 470 μm. At M12, the mean VA was 63.4 letters (p < 0.0001), 31.1% of patients had a VA > 70 letters, the mean VA change was +6.9 letters, and the mean CRT was 361.9 μm (p = 0.0001) after a mean number of 5.33 intravitreal injections. In patients who received ≥7 injections, the VA gain and final VA were significantly higher than in patients who received <7 injections. At M12, 25.45% of DME patients were lost to follow-up versus 16.8% of nAMD patients (n = 55). Discussion/Conclusion Our study confirms the real-life efficacy of ranibizumab in DME at M12 and the need for a large number of injections to achieve better visual outcomes. We also showed a trend to a lower compliance in diabetic versus nAMD patients.
Highlights
Diabetic macular edema (DME) is the leading cause of decreased vision in diabetic patients with a prevalence of 4.8% [1]
Ranibizumab was the first anti-VEGF agent to show a benefit in terms of visual acuity (VA) in the treatment of central DME [9,10,11,12] in Phase III
All consecutive patients with vision loss secondary to DME who received their first intravitreal injections (IVI) of ranibizumab 0.5 mg between June 2012 and June 2015 in a private ophthalmology center Journal of Ophthalmology specialized in retina diseases, CIL (Center for Imaging and Laser) in Paris, were retrospectively included
Summary
Diabetic macular edema (DME) is the leading cause of decreased vision in diabetic patients with a prevalence of 4.8% [1]. Laser photocoagulation has long been the reference treatment and has led to a 50% reduction in visual acuity (VA) decrease at 3 years, but this improvement is not sustained over the long term [2]. Ranibizumab was the first anti-VEGF agent to show a benefit in terms of VA in the treatment of central DME [9,10,11,12] in Phase III studies. In these pivotal studies, the VA gain over the first year varies from +6.8 to +12 letters with a number of IVI ranging between 7 and 12. The visual gain and IVI number depend on the treatment regimen and follow-up strategies used
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