Faculty Collaboration Database

Factors affecting visual outcomes in patients with diabetic macular edema treated with ranibizumab. Eye (Lond) 2014 Mar;28(3):269-78

Date

11/23/2013

Pubmed ID

24263379

Pubmed Central ID

PMC3965803

DOI

10.1038/eye.2013.245

Scopus ID

2-s2.0-84896356110 (requires institutional sign-in at Scopus site)   66 Citations

Abstract

PURPOSE: To identify factors associated with visual outcomes in patients with diabetic macular edema (DME) treated with ranibizumab (RBZ) in the Ranibizumab for Edema of the mAcula in Diabetes-Protocol 2 (READ-2) Study.

PATIENTS AND METHODS: Optical coherence tomography scans, fundus photographs, and fluorescein angiograms (FAs) were graded and along with baseline characteristics were correlated with month (M) 24 visual outcome of best-corrected visual acuity (BCVA) ≤20/100 (poor outcome) vs >20/100 (better outcome).

RESULTS: Of 101 patients with a M20 visit or beyond, 27 (27%) had BCVA ≤20/100. Comparison of patients with or without poor outcome showed mean baseline BCVA of 16.8 letters (20/125) in the former compared with 30.4 letters (20/63; P<0.001). Mean change in BCVA between baseline and M24 was -2.6 letters in the poor outcome group compared with +9.8 letters (P<0.001). Foveal thickness (FTH) at M24 was 374.1 μm in the poor outcome group compared with 268.8 μm (P<0.01), a difference driven by 14 patients with mean FTH of 450.3 μm. Foveal atrophy occurred in 65% (11/17) in the poor outcome group compared with 17%(12/71, P=0.001). Persistent edema was noted in 52% (14/27) of patients with poor outcome. Laser scars near foveal center were significantly more common in patients with poor outcome who did not have edema vs those who did (78% (7/9) vs 23% (3/13) P=0.03).

CONCLUSION: Poor baseline BCVA (≤20/125) in DME patients predicts poor visual outcome (≤20/100) after 2 years of treatment with RBZ and/or focal/grid laser, often due to foveal atrophy and/or persistent edema.

Author List

Channa R, Sophie R, Khwaja AA, Do DV, Hafiz G, Nguyen QD, Campochiaro PA, READ-2 Study Group

MESH terms used to index this publication - Major topics in bold

Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Diabetic Retinopathy
Female
Fluorescein Angiography
Humans
Intravitreal Injections
Macular Edema
Male
Middle Aged
Ranibizumab
Risk Factors
Tomography, Optical Coherence
Treatment Outcome
Vascular Endothelial Growth Factor A
Visual Acuity