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Management of macular edema due to diabetes and RVO with intravitreal ranibizumab into a monthly spectral-domain optical coherence tomography based follow-up

Session Details

Session Title: Vascular Diseases & Anterior/posterior segment surgery

Session Date/Time: Sunday 29/09/2013 | 11:00-13:00

Paper Time: 11:56

Venue: Hall 3 (Level 0)

First Author: R.Gallego-Pinazo SPAIN

Co Author(s):    R. Dolz-Marco   S. Martinez-Castillo   M. Pinazo-Duran   P. Hernandez-Martinez     

Abstract Details

Purpose:

To assess the efficacy and safety of intravitreal injections of ranibizumab in patients with naïve macular edema (ME) due to diabetes (DME) and retinal vein occlusions (RVO) in a pro re nata SD-OCT based monthly follow-up therapy approach.

Setting:

University and Polytechnic Hospital La Fe. Valencia, Spain

Methods:

The charts of all patients with ME diagnosed between October 2009 and May 2011 were retrospectively reviewed. Inclusion criteria were: diagnosis of diabetes mellitus or retinal vein occlusion (central –CRVO- or branch –BRVO- occlusion), treatment-naïve macular edema and at least 12 months of follow-up. Snellen best-corrected visual acuity (BCVA) and SD-OCT morphometric analysis were collected from baseline and 12-month follow-up visits.

Results:

Eighty diabetic patients and 45 patients with BRVO and 20 patients with CRVO met the inclusion criteria. Intravitreal ranibizumab was the only treatment performed through the follow-up, with the first injection administered at the moment of the diagnosis. All patients were followed-up for 12 months. BCVA improved from 0,37+0,25 at baseline to 0,42+0,25 (P=0,044) in DME cases; from 0.28+0.2 to 0.4 +0.25 in BRVO patients and from 0.08+0.07 to 0.29+0.27 (p=0.033) in patients with CRVO. The central subfield thickness decreased from 468.8 + 196.8 at baseline to 368,8 +158,7 microns at 12-months follow-up (P<0,001) in diabetic patients; from 447 +125 to 324+76 microns (p =0.038) in BRVO patients and from 643+148 to 281+57 microns (p=0.001).. The mean number of injections was 3,30+1.5 per patient in 12-month follow-up in diabetic patients; 3.6+1.2 injections per patient in 12-month follow-up in patients with BRVO; and 5.25+1.2 injections per patient in 12-month follow-up in patients with CRVO. There were no local or systemic complications related to the intravitreal injection of ranibizumab.

Conclusions:

Our results suggest that intravitreal injections of ranibizumab might be effective and safe in the treatment of DME and ME due to BRVO and CRVO with a pro re nata therapeutic approach. Although we report a monthly SD-OCT follow-up, the mean number of injections was 3.30, 3.6 and 5.25 respectively.

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