Factors influencing clinical outcomes in patients with diabetic macular edema treated with intravitreal ranibizumab: comparison between responder and non-responder cases

Sci Rep. 2019 Jul 29;9(1):10952. doi: 10.1038/s41598-019-47241-1.

Abstract

Diabetic macular edema (DME) is the leading cause of visual impairment in patients with diabetes mellitus. A retrospective study was conducted to investigate the factors influencing the clinical outcomes in 73 patients (94 eyes) with DME treated with intravitreal ranibizumab therapy. Baseline demographic, systemic, and ocular data were assessed for the association with visual and anatomic outcomes after treatment. The mean best corrected visual acuity (BCVA) improved from 0.92 ± 0.45 to 0.61 ± 0.43 logarithm of the minimum angle of resolution (LogMAR) (p < 0.001) after treatment. The mean central subfield macular thickness (CST) decreased from 425.2 ± 127.4 to 328.6 ± 99.4 μm (p < 0.001). The treatment response was significantly influenced by Age (p = 0.003) and baseline BCVA (p = 0.001). In addition, glycosylated hemoglobin (HbA1c) (p = 0.013) and proliferative diabetic retinopathy (PDR) (p = 0.019) were the prognostic factors for the visual outcome in the responders and non-responders, respectively. Moreover, baseline CST was the strongest predictor of anatomic outcome in all subjects (p < 0.001). Intravitreal ranibizumab for DME resulted in significant improvement in clinical outcomes. Younger age and better baseline BCVA were associated with better visual outcome after the treatment. In addition, glycemic control in the treatment of patients with DME is crucial to achieve better visual outcomes, especially in the responders to ranibizumab treatment.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Diabetes Mellitus, Type 2 / diagnostic imaging
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Retinopathy / diagnostic imaging
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Light Coagulation
  • Macular Edema / diagnostic imaging
  • Macular Edema / drug therapy*
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Ranibizumab / therapeutic use*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / drug effects

Substances

  • Angiogenesis Inhibitors
  • Ranibizumab