Visual and anatomical outcome of the diabetic macular edema treated with ranibizumab following bevacizumab failure in Israel (DERBI) study

Session Details

Session Title: Free Paper Session 24: Vascular Diseases & Diabetic Retinopathy VII

Session Date/Time: Sunday 10/09/2017 | 10:00-11:30

Paper Time: 11:18

Venue: Room 117

First Author: : J.Hanhart ISRAEL

Co Author(s): :    R. Pokroy   R. Ehrlich   O. Segal   M. Goldstein   A. Pollack   Y. Barak              

Abstract Details

Purpose:

To evaluate the functional and anatomical outcome of intravitreal ranibizumab treatment in eyes with diabetic macular edema (DME) having persistent edema unresponsive to initial therapy with intravitreal bevacizumab.

Setting:

Diabetic macular Edema treated with ranibizumab unresponsive to initial treatment with Bevacizumab in Israel (DERBI) was a retrospective, multi-centre study (n=11).

Methods:

Eyes with persistent DME following at least 4 previous consecutive bevacizumab injections prior to ranibizumab treatment were included. To be enrolled, the last 3 bevacizumab injections had to be provided in 4-6 weeks interval, and at least 12 months of follow up must have been recorded.

Results:

202 eyes were included. Patients received a mean (±SD) of 8.8±4.9 bevacizumab injections over 15.7±12 months prior to the switch to ranibizumab. 7±2.7 ranibizumab injections were provided during the 12 months following the switch to ranibizumab. The median central subfield thickness (± interquartile range) according to SD-OCT reduced from 436.0±162.0 micron at baseline to 318.5±113.0 micron at month 12 (p<0.001). The macular thickness reduced in 133 (65.8%) of the eyes by 10% or more, and in 72 of the eyes (35.6%) by 25% or more from the pre-ranibizumab value, respectively. In 15 eyes (7.4%) the macular thickness increased by 10% or more, and in 8 eyes (3.9%) macular thickness increased by 25% or more. Median logMAR visual acuity (± interquartile range) improved from 0.40±0.48 at baseline to 0.38±0.40 at month 12 (p=0.001). There was correlation between the visual acuity prior to the switch and the change in visual acuity following the switch (r=0.344, p<0.001; Spearman correlation). Vision improved by ≥1 ETDRS-line equivalent in 72 eyes (35.6%) and by ≥3 lines in 32 eyes (15.8%); vision decreased by ≥1 line in 37 eyes (18.3%), and by ≥3 lines in 13 eyes (6.4%).

Conclusions:

The DERBI study demonstrated that ranibizumab therapy in eyes with persistent DME despite prior bevacizumab therapy may be associated with both functional and anatomical improvement.

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