Predictors for 2-Year Functional and Morphological Outcomes of a Treat-and-Extend Regimen with Ranibizumab in Patients with Diabetic Macular Edema
| Autor: | Laura Hoffmann, Cengiz Türksever, Alexandra Behrndt, Maria-Magdalena Guichard, Helena Giannakaki-Zimmermann, Christian Prünte, Katja Hatz |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Visual acuity genetic structures Diabetic macular edema Angiogenesis Inhibitors Loading dose Macular Edema Cellular and Molecular Neuroscience chemistry.chemical_compound Ophthalmology Ranibizumab Medicine Humans In patient Retrospective Studies Diabetic Retinopathy business.industry Retinal General Medicine Sensory Systems eye diseases Regimen Treatment Outcome chemistry Intravitreal Injections Treat and extend regimen medicine.symptom business Tomography Optical Coherence medicine.drug Research Article |
| Zdroj: | Ophthalmic Res |
| ISSN: | 1423-0259 |
| Popis: | Purpose: The purpose of the study was to investigate longer term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat-and-extend regimen (TER) without loading dose under ranibizumab. Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency, and quantitative and qualitative spectral-domain optical coherence tomography parameters were assessed. Results: 118 eyes of 87 patients were included. A mean of 9.74 ± 2.13 injections in the first and 7.63 ± 2.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to 12 and 24 months (all p < 0.001). Percentage of eyes with an intact inner segment/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at 24 months (p < 0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p = 0.017) and after 24 months by 88.1% (p = 0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r = −0.345, p < 0.001) and better BCVA at 1 year (r = −0.347, p < 0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r = 0.305, p = 0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p = 0.046, p < 0.001). Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout 2 years. The evaluated predictors might help guide routine clinical treatment in DME. |
| Databáze: | OpenAIRE |
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