Two years outcome of effectiveness of PRN ranibizumab for diabetic macular edema – Early and late response

Poster Details

First Author: D.James UK

Co Author(s):    D. Mitkute   V. Paulpandian   D. Vayalambrone   G. Porter   C. Edelsten                 

Abstract Details


Assess effectiveness of PRN Intravitreal ranibizumab for DMO and compare results with published efficacy data . To determine whether early visual acuity response to ranibizumab in diabetic macular edema is associated with long-term outcome. To determine the influence of baseline HbA1C on the visual outcome.


Ipswich Hospital Trust


It is a retrospective study. Data was collected from e-forms maintained as a part of clinical care. All patients initiated on lucentis since 2013 until December 2016 and who had completed atleast 1 year of treatment were analysed. Inclusion criteria was in accordance to NICE guidelines. Injections were given on pro ne rata basis from the beginning. The mean visual outcome at 4 months, 12 months and 24 months were analysed. The mean change in central retinal thickness (CRT) achieved, the mean visits and injections were studied.


166 EYES OF 126 patients were analysed. The mean visual acuity (0.481 LogMAR) achieved at 4months was maintained at 2years. BCVA of better than 0.3 at baseline, 4 months, 12 months and 24 months were; 22.28%, 38.55%, 40.36% and 34.24% respectively. The mean injections in year one and two were 4.93 and 2.41 respectively and 27.39% of eyes needed 0 injections in second year. The baseline HbA1C didn’t influence the visual outcome. Subgroup analysis of eyes with 10 letters gain/loss, the long term outcome could not be predicted. Visual outcome at 12 months predicted outcome at 24 months among all subgroups.


The efficacy outcomes of PRN dosing regimen of intravitreal ranibizumab from initiation (without loading dose) in DMO at Ipswich Hospital is comparable with the published data. Moreover the visual outcome was achieved with lesser injections and hospital visits proving the cost-effectiveness of pro re nata regimen. Early visual outcome could predict long term outcome in majority of patients.

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