J Korean Ophthalmol Soc.  2010 Nov;51(11):1453-1458. 10.3341/jkos.2010.51.11.1453.

The Short-Term Efficacy of Intravitreal Ranibizumab in the Treatment of Diabetic Macular Edema

Affiliations
  • 1Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Suwon, Korea. Dhjee73@nate.com

Abstract

PURPOSE
To evaluate the short-term effect of an intravitreal injection of ranibizumab in the treatment of diabetic macular edema.
METHODS
Eighteen eyes of 18 patients who underwent intravitreal ranibizumab injection for the treatment of diabetic macular edema between March 1 and November 30, 2009 were retrospectively evaluated. Complete ophthalmic examinations including best corrected visual acuity and optical coherence tomography (OCT) were performed at baseline and follow-up visits at one and three months.
RESULTS
The mean Visual Acuity Improved From Logmar 0.74 +/- 0.45 At Baseline To Logmar 0.44 +/- 0.26 At One Month And To Logmar 0.42 +/- 0.23 At Three Months (P < 0.05). The Mean Central Macular Thickness Decreased From 429.5 +/- 71.9 microM At Baseline To 299.9 +/- 81.2 microM At One Month And To 284.6 +/- 82.6 microM At Three Months (P < 0.05). No Adverse Side Effects Were Observed Following the injections.
CONCLUSIONS
The observed macular edema and visual acuity improvements demonstrated that intravitreal ranibizumab injection may be useful for the treatment of patients with diabetic macular edema.

Keyword

Diabetic macular edema; Ranibizumab

MeSH Terms

Antibodies, Monoclonal, Humanized
Eye
Follow-Up Studies
Humans
Intravitreal Injections
Macular Edema
Retrospective Studies
Tomography, Optical Coherence
Visual Acuity
Antibodies, Monoclonal, Humanized

Figure

  • Figure 1. A change of the visual acuity (logMAR) after ranibizumab injection. Mean visual acuity prior to injection was log MAR 0.74 ± 0.45. Visual acuity increased to logMAR 0.44± 0.26, log MAR 0.42 ± 0.23, 1 and 3 months after ranibizumab injection.

  • Figure 2. A change in the central macular thickness after ranibizumab injection. Mean central macular thickness prior to injection was 429.5 ± 71.9 μ m. Central macular thickness decreased to 299.9 ± 81.2 μ m, 284.6 ± 82.6 μ m, 1 and 3 months after ranibizumab injection.


Reference

References

1. Ryan SJ. Nonproliferative diabetic retinopathy. Chew EY, Ferris FL III, editors. Retina. 4th ed.New York: Mosby, Elsevier Inc.;2006. 2:chap.p. 67.
2. Aiello LP. Angiogenic pathways in diabetic retinopathy. N Engl J Med. 2005; 353:839–41.
Article
3. Hardy RA, Crawford JB. Retina. Vaughn D, Asbury T, Riordan-Eva P, editors. General Ophthalmology. 15th ed.Stamford, CT: Appleton & Lange;1999. p. 178–99.
4. Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984; 91:1464–74.
5. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number. Arch Ophthalmol. 1985; 103:1796–805.
6. Nguyen QD, Shah SM, Van Anden E, et al. Supplemental oxygen improves diabetic macular edema: a pilot study. Invest Ophthalmol Vis Sci. 2004; 45:617–24.
Article
7. Vinores SA, Youssri AI, Luna JD, et al. Upregulation of vascular endothelial growth factor in ischemic and non-ischemic human and experimental retinal disease. Histol Histopathol. 1997; 12:99–109.
8. Antcliff RJ, Marshall J. The pathogenesis of edema in diabetic maculopathy. Semin Ophthalmol. 1999; 14:223–32.
Article
9. Funatsu H, Yamashita H, Ikeda T, et al. Vitreous levels of inter-leukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology. 2003; 110:1690–6.
Article
10. Funatsu H, Yamashita H, Sakata K, et al. Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema. Ophthalmology. 2005; 112:806–16.
Article
11. Spaide RF, Fisher YL. Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage. Retina. 2006; 26:275–8.
Article
12. Haritoglou C, Kook D, Neubauer A, et al. Intravitreal bevacizumab (Avastin) therapy for persistent diffuse diabetic macular edema. Retina. 2006; 26:999–1005.
Article
13. Presta LG, Chen H, O'Connor SJ, et al. Humanization of an antivascular endothelial growth factor monoclonal antibody for the therapy of solid tumors and other disorders. Cancer Res. 1997; 57:4593–9.
14. Fischer S, Renz D, Schaper W, Karliczek GF. In vitro effects of dexamethasone on hypoxia-induced hyperpermeability and expression of vascular endothelial growth factor. Eur J Pharmacol. 2001; 411:231–43.
Article
15. Bandi N, Kompella UB. Budesonide reduces vascular endothelial growth factor secretion and expression in airway (Calu-1) and alveolar (A549) epithelial cells. Eur J Pharmacol. 2001; 425:109–16.
Article
16. Oh SB, Moon JW, Kim HC. Comparison of effects of intravitreal triamcinolone and bevacizumab in the treatment of diabetic macular edema. J Korean Ophthalmol Soc. 2009; 50:1190–6.
Article
17. Lee JW, Lee BH, Lim JH, Lee KW. Intravitreal triamcinolone versus bevacizumab for treatment of diabetic macular edema. J Korean Ophthalmol Soc. 2009; 50:1184–9.
Article
18. Erol N, Topbas S, Sahin A. Retinal break following an intravitreal triamcinolone acetonide injection. Int Ophthalmol. 2005; 26:163–5.
Article
19. Ung T, Williams CP, Canning CR. Globe rupture as a complication of intravitreal injection of triamcinolone. Eye. 2007; 21:423–4.
Article
20. Sampat KM, Garg SJ. Complications of intravitreal injections. Curr Opin Ophthalmol. 2010; 21:178–83.
Article
21. Toh T, Borthwick JH. Acute retinal necrosis post intravitreal injection of triamcinolone acetonide. Clin Experiment Ophthalmol. 2006; 34:380–2.
Article
22. Gillies MC, Simpson JM, Billson FA, et al. Safety of an intravitreal injection of triamcinolone: results from a randomized clinical trial. Arch Ophthalmol. 2004; 122:336–40.
23. Jager RD, Aiello LP, Patel SC, et al. Risks of intravitreous injection: a comprehensive review. Retina. 2004; 24:676–98.
Article
24. Ferrara N. Vascular endothelial growth factor: basic science and clinical progress. Endocr Rev. 2004; 25:581–611.
Article
25. Boulton M, Foreman D, Williams G, McLeod D. VEGF localisation in diabetic retinopathy. Br J Ophthalmol. 1998; 82:561–8.
Article
26. Campochiaro PA. C99-PKC412–003 Study Group. Reduction of diabetic macular edema by oral administration of the kinase inhibitor PKC412. Invest Ophthalmol Vis Sci. 2004; 45:922–31.
Article
27. Chun DW, Heier JS, Topping TM, et al. A pilot study of multiple intravitreal injections of ranibizumab in patients with center-in-volving clinically significant diabetic macular edema. Ophthalmology. 2006; 113:1706–12.
Article
28. Nguyen QD, Tatlipinar S, Shah SM, et al. Vascular endothelial growth factor is a critical stimulus for diabetic macular edema. Am J Ophthalmol. 2006; 142:961–9.
Article
29. Nguyen QD, Shah SM, Heier JS, et al. Primary end point (Six months) results of the Ranibizumab for edema of the macular in diabetes (READ-2) study. Ophthalmology. 2009; 116:2175–81.
30. Fung AE, Rosenfeld PJ, Reichel E. The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide. Br J Ophthalmol. 2006; 90:1344–9.
Article
31. Jonas JB, Spandau UH, Schlichtenbrede F. Short-term complications of intravitreal injections of triamcinolone and bevacizumab. Eye. 2008; 22:590–1.
Article
32. Apte RS. Retinal pigment epithelial tear after intravitreal ranibizumab for subfoveal CNV secondary to AMD. Int Ophthalmol. 2007; 27:59–61.
Article
33. Smith BT, Kraus CL, Apte RS. Retinal pigment epithelial tears in ranibizumab-treated eyes. Retina. 2009; 29:335–9.
Article
34. Angulo Bocco MC, Glacet-Bernard A, Zourdani A, et al. [Intravitreous injection: retrospective study on 2028 injections and their side effects] J Fr Ophthalmol. 2008; 31:693–8.
35. Ladas ID, Karagiannis DA, Rouvas AA, et al. Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections. Retina. 2009; 29:313–8.
36. Stewart MW. Predicted biologic activity of intravitreal aberrations. Retina. 2007; 27:1196–200.
37. Kim SJ, Park YM, Lee SU, et al. Short-term safety and efficacy of intravitreal Bavacizumab injection. J Korean Ophthalmol Soc. 2009; 50:219–26.
Article
38. Pieramici DJ, Rabena MD. Anti-VEGF therapy: comparison of current and future agents. Eye. 2008; 22:1330–6.
Article
39. Gharbiya M, Giustolisi R, Allievi F, et al. Choroidal aberrations in pathologic myopia: intravitreal Ranibizumab versus Bevacizumab— a randomized controlled trial. Am J Ophthalmol. 2010; 149:458–64.
40. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355:1419–31.
Article
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