Clinical Study | Published:

Identification of time point to best define ‘sub-optimal response’ following intravitreal ranibizumab therapy for diabetic macular edema based on real-life data

Eye volume 31, pages 15941599 (2017) | Download Citation

Abstract

Purpose

To determine the average time-point at which it is best to define ‘sub-optimal response’ after ranibizumab treatment for diabetic macular edema (DME) based on the data obtained from real-life clinical practice.

Methods

In this retrospective observational study, 322 consecutive treatment naïve eyes with DME were treated with three loading doses of intravitreal ranibizumab followed by re-treatment based on decision of the treating physician on a case-by-case basis. The demographic data, clinic-based visual acuity measurements and central subfield thickness (CST) assessed on spectral domain optical coherence tomography (OCT) were evaluated at baseline (month 0), 1, 2, 3, 6, and 12 months.

Results

On an average, the improvement in visual acuity and CST was first seen after the loading dose. However, the maximal response in terms of proportion of patients with improvement in visual acuity and/ or CST in this cohort was observed at 12 months. Patients who presented with low visual acuity at baseline (<37 ETDRS letters) were unlikely to attain driving vision with ranibizumab therapy.

Conclusions

On an average, a ‘sub-optimal response’ after ranibizumab therapy is best defined at month 12 as patients may continue to improve with treatment.

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Author information

Affiliations

  1. National Institute for Health Research, Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust and UCL Institute of Ophthalmology, London, UK

    • I Chatziralli
    • , M Santarelli
    • , N Patrao
    • , L Nicholson
    • , M Zola
    • , R Rajendram
    • , P Hykin
    •  & S Sivaprasad

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Competing interests

PH and SS have received travel grants, research grants and speaker fees and attended advisory board meetings of Bayer, Allergan and Novartis.

Corresponding author

Correspondence to S Sivaprasad.

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DOI

https://doi.org/10.1038/eye.2017.111