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Diabetic macular edema: challenges in the anti-VEGF treatment

Session Details

Session Title: Vascular Diseases I

Session Date/Time: Friday 27/09/2013 | 08:00-10:00

Paper Time: 08:00

Venue: Hall C (Level 1)

First Author: T.Josifova SWITZERLAND

Co Author(s):    P. Henrich              

Abstract Details


Purpose: To compare the results of the patients who received one, two or three Anti-VEGF injections in the “uploading treatment” of DME.


The study was performed at the Medical Retina Department- University Hospital, Eye Clinic, Basel.


Methods: 66 patients were included in the study, treated with intravitreal Anti-VEGF therapy with single dosage (one injection of Ranimizumab-0,05ml/50 μgr.), two, or three Ranimizumab injections monthly. Inclusion criteria: Intraretinal cystoid diabetic macular edema (DME), no laser treatment in the last three months, no Anti-VEGF therapy in the last three months. HBA1C in the last three months < 7,0 % no-hypertension, or drug regulated hypertension. OCT investigation was performed monthly. BCVA was proved on the ETDRS Chart, at the same time with OCT investigations. Follow-up period in the study group was 12 months.


Results: The OCT investigation related results showed regression of DME after the single injection in: 18/66 (27,2%) patients. Two-injections DME regression was seen in 15/66 (22,7%) and three injection DME-regression in 20/66 (30,3%)patients. In 13/66 patients (19,6%) , after the third injection there was a still persistent DME. BCVA improvement (at least 5 letters) after the DME regression in single-injection group, was seen in 13/18 (72,2%) patients, in two-injections group in 11/15 (73,3%), and in three-injections group in 15/20 (75,0%) patients. Recidivist DME in single-Ranimizumab injection group was noted after average 3,9 months; in two Ranimizumab injections group recidivism was present in average of 3,8 months, and in three-injections group in 4,4 months.


Conclusion: In our study group the results showed that the up-loading dosage of Ranimizumab intravitreal should not necessarily include 3 injections of Ranimizumab. Also the BCVA and recidivism of DME is not directly correlated to the number of injections. We advise monthly OCT and BCVA controls in order to make the decision for the need of further application of Ranimizumab injections.

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