First Author: M.Lafuente SPAIN
Co Author(s): J.L. Guindo M. Argente L. Ortín J.C. Domingo J. Lopez Roman D. López Bernal 0 0 0 0 0 0 0 0 0
Back to previous
To evaluate one-year efficacy of Ranibizumab in best-corrected visual acuity (BCVA), Central retinal thickness (CRT) and oxidative plasma biomarkers levels in patients with diabetic macular edema treated with intravitreal Ranibizumad and oral DHA supplementation.
76 eyes of 62 patients with visual impairment due to diabetic macular edema (DME) were studied. 50% of them received standard Ranibizumab treatment alone, and the rest were given Rabinizumab + oral DHA supplementation.
All patients were treated with monthly intraviteal Ranibizumab (0.05mg) the first four months and then revised monthly and treated on an as-needed (PRN) basis. Retreatment criteria were: a variation in CRT of 100 μm and/or a variation in 5 letters of the Early Treatment Diabetic Retinopathy Study charts in BCVA. 50% of patients received an additional oral suplementation with 1500 mg of daily DHA. Differences on BCVA, CRT, number of inyections required and total plasma antioxidant capacity (TPAC) were studied in both groups.
12 months after monthly treatment with intravitreal Ranibizumab BCVA was improved in all patients from 0.48 ± 0,2 LogMar at baseline to 0,27 ± 0,19 logMAR at 12th month (p < 0.0001). There was a progressive BCVA improvement until month nine and then stabilized. Oral supplementation with DHA didn’t affect these results. 55% of patients gained more than 10 letters and 25% more than 15 letters at the end of the study. A CRT reduction from baseline (446 ± 104 μm) to the end point (336 ± 66 μm, p< 0.001) was observed. This reduction was greater in patients who received oral supplementation with DHA (p< 0.035). Patients in both groups received a mean of 6.6 injections independently of oral supplementation with DHA. TPAC increased significantly only in DHA-treated patients (p<0.00001).
Monthly Ranibizumab on an as-needed basis was effective in improving BCVA in 77% of patients. Ranibizumab + DHA improved plasma antioxidant capacity and CRT further compared with Rabinizumab alone.