First Author: C.Perpétua PORTUGAL
Co Author(s): R. Couceiro R. Amorim I. Leal N. Pinto Ferreira J. Prates Canelas M. Monteiro Grillo 0 0 0 0 0 0 0 0 0
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To evaluate the effect of glucose regulation on the structural and functional outcome of intravitreal ranibizumab injection for clinically significant diabetic macular edema (CSDME).
Diabetic retinopathy is major complication of Diabetes. The metabolic control might be a key factor for development, progression and treatment of diabetic retinopathy complications.
Retrospective study, 20 eyes of 20 patients with CSDME treated with intravitreal ranibizumab injection, with no previous anti-VEGF treatment performed. The best corrected visual acuity (BCVA) and the central subfield macular thickness (CSMT) measured with optical coherence tomography (OCT) were evaluated prior and 4-8 weeks after intravitreal ranibizumab injection treatment. The correlation between the baseline and final BCVA and CSMT, with the serum hemoglobin A1c values (HbA1c) was evaluated.
The study included 9 (45%) female and 11 (55%) male patients, with a mean age of 62.35 (±10.00) years. The mean time since Diabetes diagnosis was 18.90 (±8.93) years, 2 patients (10%) had Diabetes type 1, and 18 patients (90%) had Diabetes type 2. At baseline examination, the mean BCVA was 20/50, and the mean CSMT was 467 (±112) μm. The mean serum HbA1c of the patients was 8.23% (±1.56). After treatment, the mean BCVA increased to 20/40 and the mean CSMT decreased to 356 (±73) μm. The change in the mean BCVA and CSMT was significant (P=0.003 for BCVA; P<0.001 for CSMT). There was no significant correlation between the serum HbA1c and the baseline BCVA (R=0.024, P=0.920), and CSMT (R=-0.204, P=0.387). There was a negative and average correlation between serum HbA1c values and the final BCVA (R=-0.380, P=0.099). There was a positive and statistically significant correlation between serum HbA1c values and final CSMT (R=0.462, P=0.040).
Glucose regulation has an impact on structural and functional outcome of intravitreal ranibizumab injection for clinically significant diabetic macular edema. The present study emphasizes the importance of metabolic control, not only to prevent diabetic retinopathy and its progression, but also to improve treatment outcome.