Details

Autor(en) / Beteiligte

• Channa, R
• Sophie, R
• Khwaja, A A
• Do, D V
• Hafiz, G
• Nguyen, Q D
• Campochiaro, P A

Titel

Factors affecting visual outcomes in patients with diabetic macular edema treated with ranibizumab

Ist Teil von

• Eye (London), 2014-03, Vol.28 (3), p.269-278

Ort / Verlag

London: Nature Publishing Group UK

Erscheinungsjahr

2014

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Purpose To identify factors associated with visual outcomes in patients with diabetic macular edema (DME) treated with ranibizumab (RBZ) in the Ranibizumab for Edema of the mAcula in Diabetes—Protocol 2 (READ-2) Study. Patients and methods Optical coherence tomography scans, fundus photographs, and fluorescein angiograms (FAs) were graded and along with baseline characteristics were correlated with month (M) 24 visual outcome of best-corrected visual acuity (BCVA) ≤20/100 (poor outcome) vs >20/100 (better outcome). Results Of 101 patients with a M20 visit or beyond, 27 (27%) had BCVA ≤20/100. Comparison of patients with or without poor outcome showed mean baseline BCVA of 16.8 letters (20/125) in the former compared with 30.4 letters (20/63; P <0.001). Mean change in BCVA between baseline and M24 was −2.6 letters in the poor outcome group compared with +9.8 letters ( P <0.001). Foveal thickness (FTH) at M24 was 374.1  μ m in the poor outcome group compared with 268.8  μ m ( P <0.01), a difference driven by 14 patients with mean FTH of 450.3  μ m. Foveal atrophy occurred in 65% (11/17) in the poor outcome group compared with 17%(12/71, P =0.001). Persistent edema was noted in 52% (14/27) of patients with poor outcome. Laser scars near foveal center were significantly more common in patients with poor outcome who did not have edema vs those who did (78% (7/9) vs 23% (3/13) P =0.03). Conclusion Poor baseline BCVA (≤20/125) in DME patients predicts poor visual outcome (≤20/100) after 2 years of treatment with RBZ and/or focal/grid laser, often due to foveal atrophy and/or persistent edema.