Effect of Vitreomacular Adhesion on Treatment Outcomes in the Ranibizumab for Edema of the Macula in Diabetes (READ-3) Study

Sadiq, Mohammad Ali; Soliman, Mohamed Kamel; Hanout, Mostafa; Sarwar, Salman; Agarwal, Aniruddha; High, Robin; Diana, V.; Nguyen, Quan Dong; Sepah, Yasir J.

doi:10.1016/j.ophtha.2015.09.032

Cited by 50 publications

(48 citation statements)

References 18 publications

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“…A retrospective cohort study of 124 eyes enrolled in the READ-3 trial found that eyes with evidence of vitreomacular adhesion at baseline ( n = 26) had a greater improvement in visual acuity than those without VMA ( n = 98) at 6 months following treatment with ranibizumab [12]. In this study, however, patients with VMT were excluded from the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Intravitreal injections of anti-VEGFs (or other substances) may alter the anatomical structure of the vitreous leading to changes in the status of the posterior hyaloid [10, 12]. The posterior hyaloid, previously attached, could detach as a result of these changes, and this could potentially modify the course of DMO, even leading to its resolution.…”

Section: Introductionmentioning

confidence: 99%

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Vitreomacular interface abnormalities in patients with diabetic macular oedema and their implications on the response to anti-VEGF therapy

Mikhail

Stewart

Seow

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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PurposeTo determine whether the presence of vitreomacular interface abnormalities (VMIA) in patients with diabetic macular oedema (DMO) modifies the response to ranibizumab.MethodsMedical records and spectral-domain optical coherence tomography (SD-OCT) scans of consecutive patients with centre-involving DMO initiating therapy with ranibizumab between December 2013 and March 2014 at the Belfast Health and Social Care Trust were reviewed. Patients were identified through an electronic database. Demographics; systemic baseline characteristics; history of previous ocular surgery/laser; best-corrected visual acuity (BCVA), central retinal thickness (CRT) and stage of retinopathy at presentation; and BCVA, CRT and presence/absence of fluid at the last follow-up were recorded. OCT scans were reviewed by a masked investigator who graded them for the presence/absence of VMIA at baseline and during follow-up and for the change in the posterior hyaloid face during follow-up. The association between (1) VMIA at baseline and (2) the change in the posterior hyaloid face during the follow-up and functional/anatomical outcomes was evaluated.ResultsOne hundred forty-six eyes of 100 patients (mean age 63.5 years) followed for a mean of 9 months (range 2–14 months; only 9/146 dropped to follow-up before month 6) were included. Statistically significant differences were observed at baseline in BCVA (p = 0.007), previous macular laser and panretinal photocoagulation (PRP) (p = 0.006) and previous cataract surgery (p = 0.01) between eyes with and without VMIA, with better levels of vision, higher frequency of macular laser and lower frequency of PRP in eyes where no VMIA was present. Multivariable regression analysis did not disclose any statistically significant associations between VMIA at baseline or change in the posterior hyaloid face during the follow-up and functional and anatomical outcomes following treatment.ConclusionVMIA are associated with worse presenting vision in patients with DMO; VMIA or change in the posterior hyaloid face during the follow-up did not modify the response to ranibizumab in this study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vitreomacular interface abnormalities in patients with diabetic macular oedema and their implications on the response to anti-VEGF therapy

Mikhail

Stewart

Seow

et al. 2018

Graefes Arch Clin Exp Ophthalmol

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“…However, these findings are consistent with recent literature examining the role of VMA on visual and anatomic outcomes for both diabetic ME and BRVO treated with anti-VEGF. A retrospective study done by Sadiq et al 22 based on data from the READ-3 trial found that diabetic ME patients with VMA had significantly greater gains in BCVA and improvement in OCT compared with VMA-negative patients. Another study by Terao et al 23 looked at the effect of VMA on treatment outcomes for BRVO with anti-VEGF therapy and found that the VMA-positive group showed more improvement in BCVA than did the VMA-negative group (p=0.0150), and a greater decrease in CST after adjusting for age (p=0.0019).…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of the influence of the vitreomacular interface on macular oedema secondary to retinal vein occlusion

et al. 2017

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“…The results at 24 months confirmed PRN 2.0 mg intravitreal RBZ did not seem to provide additional benefits over PRN 0.5 mg RBZ after 6 month loading doses. In a retrospective cohort study of month-6 primary outcomes in the READ-3 study, patients with DME and vitreomacular adhesion (VMA) were analyzed [24] . The study showed that intravitreal RBZ has a greater potential for visual improvement in DME patients with VMA.…”

confidence: 99%

Intravitreal Ranibizumab in Diabetic Macular Edema: Long-Term Outcomes

Zucchiatti¹,

Bandello²

2017

Management of Diabetic Retinopathy

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Intravitreal ranibizumab (RBZ) has been shown in multiple randomized clinical trials to be a valuable treatment for diabetic macular edema (DME), promoting a significant improvement in best-corrected visual acuity (BCVA) and in anatomic outcomes. Compared to sham (RISE and RIDE studies), RBZ rapidly and sustainably improved BCVA and decreased macular edema at 2 years, reducing the risk of further vision loss, with low rates of local or systemic side effects. Compared to macular laser photocoagulation (READ-2 study), RBZ provided a greater improvement in BCVA and regression in foveal thickness, but required a higher number of injections compared to patients treated with both RBZ and laser. In RESTORE trial, RBZ alone or combined with macular laser turned out to be superior to laser alone, without significant differences between the 2 RBZ groups. Compared to combined treatment (RBZ or triamcinolone associated with macular laser) or photocoagulation laser alone (Diabetic Retinopathy Clinical Research Network trial), RBZ with prompt or deferred laser was more effective than laser alone at 1-year follow-up. At 3 years, prompt laser was not better than deferring laser for 24 weeks or more. At 5 years, subjects treated with RBZ achieved better long-term visual outcomes than patients managed with triamcinolone or laser followed by very deferred RBZ. In conclusion, randomized clinical trials showed that RBZ was superior to laser in DME treatment, providing excellent long-term visual outcomes. Frequent injections were necessary in most of the patients to properly control DME and maximize the visual benefits.

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Effect of Vitreomacular Adhesion on Treatment Outcomes in the Ranibizumab for Edema of the Macula in Diabetes (READ-3) Study

Cited by 50 publications

References 18 publications

Vitreomacular interface abnormalities in patients with diabetic macular oedema and their implications on the response to anti-VEGF therapy

Vitreomacular interface abnormalities in patients with diabetic macular oedema and their implications on the response to anti-VEGF therapy

A retrospective study of the influence of the vitreomacular interface on macular oedema secondary to retinal vein occlusion

Intravitreal Ranibizumab in Diabetic Macular Edema: Long-Term Outcomes

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