Short-term effects of intravitreal ranibizumab therapy on diabetic macular edema

Minami, Yoshiro; Nagaoka, Taiji; Ishibazawa, Akihiro; Yoshida, Akitoshi

doi:10.1186/s12886-017-0420-8

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…Similarly, Gonzalez reported that the BCVA at 12 weeks after a ranibizumab injection for DME was significantly associated with the outcome at 3 years [ 9 ]. In addition, two other studies have reported that the short-term effects (1 day to 3 months) can predict the therapeutic outcome of the anti-VEGF treatment for DME [ 10 , 11 ]. Thus, the earlier prediction is desirable from a patient’s burden, and it would be ideal if the therapeutic effects could be predicted only by the response to the first injection.…”

Section: Discussionmentioning

confidence: 99%

“…We calculated the sample size needed for power with an effect size of 0.3, α-error of 0.05, and power of 0.95, and found that the total sample size was estimated to be 34 for each group. Although there is a possibility of a small sample size for our study, previous similar studies also reported that short-term effects can predict the therapeutic outcome of the anti-VEGF treatment of DME with a small number of fewer than 20 eyes [ 10 , 11 ]. Therefore, we believe that our results are reliable for determining short-term effects.…”

Section: Discussionmentioning

confidence: 99%

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Response to Initial Anti-Vascular Endothelial Growth Factor for Diabetic Macular Edema Is Significantly Correlated with Response to Third Consecutive Monthly Injection

Maeda

Sugimoto

Tenma

et al. 2022

JCM

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Purpose: To determine whether the response to the initial anti-vascular endothelial growth factor (anti-VEGF) injection to treat diabetic macular edema (DME) is significantly correlated with the response to the third consecutive monthly injection of the same anti-VEGF agent. Methods: Seventy eyes with DME that were treated with an anti-VEGF agent (16 eyes with 1.25-mg bevacizumab, 35 eyes with 0.5-mg ranibizumab, and 19 eyes with 2.0-mg aflibercept) were studied. They were treated with three consecutive monthly injections of one of the three anti-VEGF agents. The best-corrected visual acuity (BCVA) in the logarithm of the minimum angle of resolution (logMAR units) and the central macular thickness (CMT) were measured at the baseline, 1 week after the initial injection, and 1 month after the third consecutive monthly injection. The changes of both values from the baseline 1 week after the initial injection (day 7) and 1 month after the third monthly injection were determined. The significance of the correlations between the BCVA and the CMT was determined. Results: The mean BCVA improved significantly for all three agents (0.38 ± 0.22 logMAR units at the baseline to 0.27 ± 0.25 logMAR units) after the three monthly injections (p < 0.05, repeated ANOVA). For all cases, a moderate but significant correlation was found between the BCVA at day 7 and 1 month after the third injection (r = 0.58, p < 0.01; Spearman’s rank correlation). No significant correlation was found for bevacizumab (r = 0.09, p = 0.73), moderate correlation was found for ranibizumab (r = 0.42, p < 0.05), and a strong correlation was found for aflibercept (r = 0.83, p < 0.001) between the BCVA at day 7 and at 1 month after the third injection. The mean CMT improved significantly for all three agents (481.9 ± 96.3 μm at the baseline to 364.1 ± 116.0 μm after the three monthly injections, p < 0.05), and a moderate correlation was found for the three agents between CMT at day 7 to that at one month after the third anti-VEGF injection (r = 0.54, p < 0.01). A moderate correlation was found for all three agents between CMT at day 7 to that at one month after the third anti-VEGF injection (r = 0.68 for bevacizumab, r = 0.41 for ranibizumab and r = 0.53 for aflibercept, p < 0.05). Conclusions: The significant correlations between the results on day 7 to that one month after the third anti-VEGF treatment for DME indicates that the long-term effects of anti-VEGF therapy can be predicted by the short-term response. In addition, the results indicate that there may be differences in the effectiveness between the three anti-VEGF agents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Response to Initial Anti-Vascular Endothelial Growth Factor for Diabetic Macular Edema Is Significantly Correlated with Response to Third Consecutive Monthly Injection

Maeda

Sugimoto

Tenma

et al. 2022

JCM

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“…Although antivascular endothelial growth factor (VEGF) treatment remains the first-line treatment for DME, the use of adjunct laser treatment has been shown to reduce the number of injections necessary for patient management [ 29 – 43 ]. The results of future clinical studies are needed to corroborate our present findings and validate the utility of subthreshold photocoagulation.…”

Section: Discussionmentioning

confidence: 99%

Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema

Hamada

Ohkoshi

Inagaki

et al. 2018

Journal of Ophthalmology

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We evaluated subthreshold photocoagulation using endpoint management (EPM) for the treatment of diabetic macular edema (DME). The study enrolled 10 eyes from 10 patients (6 men and 4 women) with DME. The entry criteria included central macular thickness (CMT) ≥ 300 μm and decimal visual acuity (VA) ≤ 0.5. The primary endpoints were VA (logMAR) and CMT at 6 months follow-up. Secondary endpoints included fundus autofluorescence, macular volume (MV), and macular sensitivity (MS). We used the PASCAL Streamline Yellow® (wavelength, 577 nm) system to perform grid pattern laser photocoagulation at 50% of the threshold (size, 100 μm; duration, 0.015 s; spacing, 0.5; and energy, 4.5–7.8 mJ). At 6 months posttreatment, CMT was significantly decreased, while there were no significant changes in macular sensitivity, mean BCVA (logMAR), or macular volume. Autofluorescence imaging revealed no changes after treatment in 6 of 10 eyes. No eyes exhibited subjective symptoms of scotoma after photocoagulation. Optical coherence tomography showed the complete resolution of macular edema in 4 eyes (40%) after a single treatment; MS was increased in all 4 of these eyes at 6 months posttreatment. In conclusion, subthreshold photocoagulation using EPM is safe and effective for DME treatment and preserves MS. This trial is registered with UMIN000012401.

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“…(2017) who demonstrated that there was a significant (p < 0.05) correlation between the Δ CMT-1w and ΔVA-1w in the present study. Further researches with a large sample size are required to verify the association between the improvements in BCVA and improvements in CMT 35 .…”

Section: In the Same Line Comparable Duration Was Recorded Bymentioning

confidence: 99%

Ranibizumab Response in Diabetic Macular Edema at Mansoura Ophthalmology Center

Elbeheiri

El-Tarshouby

Abouelkheir

et al. 2022

Egyptian Journal of Ophthalmology, (Mansoura Ophthalmic Center)

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Diabetic macular edema (DME) is a complicated disease due to a multifactorial process comprising the breakdown of the blood retinal barrier with a subsequent fluid accumulation in the macula. Treatment of DME depends recently on more successful therapies such as anti-vascular endothelial growth factor (VEGF) therapies that could stabilize or improve vision in several cases. Ranibizumab has been submitted for approval as a treatment of visual impairment owing to DME.Objective: To assess the response of intravitreal injection (IVI) of ranibizumab in DME at Mansoura ophthalmology center. Patients and methods:This were a prospective study carried out on a total of 50 diabetic cases with DME. Full history was taken from included cases and full ophthalmological examination was conducted in addition to evaluation of the macular retinal maps using optical coherence tomography (OCT) (Spectral domain OCT 2000). Three monthly consecutive intravitreal injections of anti-VEGF of ranibizumab at a dosage of 0.5mg/0.05 ml were administered to all the cases.Results: There was highly statistically significant improvement in the visual acuity (VA) and highly statistically significant reduction in the macular thickness in the included cases after one month and after three months as compared with the pretreatment value (P<0.001). The degree of diabetic control didn't appear to affect the change of the macular thickness. Conclusion:The intravitreal ranibizumab injection effectively decreased macular thickness and improved VA. The structural and functional effects of ranibizumab appeared as early as after 1 month of treatment and maintained at 3 months following treatment.

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Short-term effects of intravitreal ranibizumab therapy on diabetic macular edema

Cited by 7 publications

References 23 publications

Response to Initial Anti-Vascular Endothelial Growth Factor for Diabetic Macular Edema Is Significantly Correlated with Response to Third Consecutive Monthly Injection

Response to Initial Anti-Vascular Endothelial Growth Factor for Diabetic Macular Edema Is Significantly Correlated with Response to Third Consecutive Monthly Injection

Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema

Ranibizumab Response in Diabetic Macular Edema at Mansoura Ophthalmology Center

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