Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema

Purpose Intravitreal anti-vascular endothelial growth factor (VEGF) agents are effective in the treatment of central involving diabetic macular oedema (DMO). Vitreoretinal interface abnormalities (VRIA) are common in patients with DMO, and the effect of these on the response to anti-VEGF treatment i...

Full description

Saved in:
Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 2017-04, Vol.255 (4), p.733-742
Main Authors: Wong, Yun, Steel, David H. W., Habib, Maged S., Stubbing-Moore, Alex, Bajwa, Dalvir, Avery, Peter J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiogenesis Inhibitors - administration & dosage
Diabetic Retinopathy - complications
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - drug therapy
Female
Follow-Up Studies
Humans
Intravitreal Injections
Macular Edema - complications
Macular Edema - diagnosis
Macular Edema - drug therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Ophthalmology
Prospective Studies
Ranibizumab - administration & dosage
Retina - drug effects
Retina - pathology
Retinal Disorders
Time Factors
Tissue Adhesions - diagnosis
Tissue Adhesions - etiology
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A
Visual Acuity
Vitreous Body - drug effects
Vitreous Body - pathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Intravitreal anti-vascular endothelial growth factor (VEGF) agents are effective in the treatment of central involving diabetic macular oedema (DMO). Vitreoretinal interface abnormalities (VRIA) are common in patients with DMO, and the effect of these on the response to anti-VEGF treatment is unclear. Furthermore the effect of anti-VEGF agents on the VRIA itself is uncertain. Method Prospective study of consecutive patients treated with ranibizumab (RZB) for DMO as part of routine clinical care in one eye unit over a 1-year period. Visual acuity (Va), central retinal thickness (CRT) and injection frequency data was recorded on an electronic database. Treatment was initiated with four monthly RZB injections and then a monthly PRN regime. All patients underwent high-density spectral-domain optical coherence tomography (SDOCT) at baseline and 12 months. The SDOCTs were graded by two observers masked to the outcome. Results One hundred and four eyes (77 patients) were included in the analysis. The mean age was 62 years, and 62% were male. The mean presenting vision was 62 letters and CRT 472 μm. Eighty eyes retained stable Va, and 17 had an improvement in Va. At baseline, 39 eyes had associated focal vitreomacular adhesion (VMA) and by 12 months this reduced to 30 ( p  = 0.04), with 12 releasing VMA and three developing it. Patients with VMA had significantly better final Va than those without VMA. Improvement in CRT was greatest in those where VMA released during the study. Forty-five eyes had some degree of foveal involving epiretinal membrane (ERM) at baseline, and 28 were considered to have clinically significant ERM. There was no clinically relevant change in ERM during the study. Patients with significant ERM at baseline had a lower final vision. Multivariate analysis showed that ERM and more severe retinopathy at baseline were predictive of less visual improvement ( p
ISSN:0721-832X
1435-702X
DOI:10.1007/s00417-016-3562-0