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Macular electrophysiological study in a cohort of type 2 diabetic patients diagnosed with diffuse macular edema after being treated with ranibizumab

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy IV

Session Date/Time: Sunday 20/09/2015 | 09:00-10:30

Paper Time: 09:32

Venue: Athena.

First Author: : M.Baget SPAIN

Co Author(s): :    P. RomeroAroca   A. Bautista   J. Mercado        

Abstract Details

PURPOSE:To evaluate the initial electrophysiological macular profile in a sample of thirty four eyes diagnosed with diffuse diabetic macular edema (DME) and subsequently, assess the changes occurred after being treated with ranibizumab for a period of 1 year.

Setting:

All 22 patients enrolled in this prospective study were evaluated in the Department of Ophthalmology at the hospital of the University Rovira i Virgili in Reus, Catalonia.

Methods:

Thirty-four eyes from 22 type 2 diabetic patients were initially assessed and subsequently, after being treated with ranibizumab for a period of 12 months. For this purpose, each eye underwent a complete retinal evaluation. According to the optical coherence tomography (SD-OCT), each eye was initially classified as having cystoid, spongiform or serous macular edema. At the same time, the integrity of the inner segment/outer segment (IS/OS) and external limiting membrane (ELM) lines, was measured quantitetively (in microns) at the fovea. In addition, each eye was graded with respect to its retinopathy. The treatment regimen with ranibizumab consisted of three loading doses and then pro re nata monthly dosing of it. The main functional variables studied during the follow-up period were the macular response density (RD) and the implicit time (IT) of the standard multifocal electroretinogram (mf-ERG) at the fovea.

Results:

The eyes with cystoid and spongiform DME showed initially better RD r= 0,68 (p: 0,003). Eyes with moderate retinopathy had better RD and shorter IT with respect to those classified as having severe or proliferative retinopathy r= 0,77 (p;0,001). The eyes that showed greater integrity in the IS/OS r= 0,34 (p: 0,04) and ELM lines r= 0,33 (p: 0,04) had the best RD. Once the treatment was initiated with ranibizumab, it was observed an improvement in the RD at 6 and 12 months, specially in those eyes with initially greater IS/OS and ELM integrity r= 0,81(p;0,0001) and in spongiform eyes r=0,77 (p;0,0001). In addition, a significant improvement in both the integrity of the IS/OS (108,79 ± 274,90 μm ) and the ELM 100,88 ± 181,70 μm) lines was observed at the fovea.

Conclusions:

Ranibizumab demonstrated a significant improvement in the electrophysiological profile at the fovea in eyes with DME. The mf-ERG is a useful tool for monitoring the patients with DME that are being treated with ranibizumab.

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