Ranibizumab 0.3 mg for Persistent Diabetic Macular Edema After Recent, Frequent, and Chronic Bevacizumab: The ROTATE...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacological Interventions

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Persistent DME after bevacizumab treatment poses a clinical challenge.
• Evaluating alternative treatments is crucial for managing refractory DME.

Purpose of the Study:

• To assess the safety and efficacy of 0.3 mg ranibizumab in eyes with persistent DME.
• To compare outcomes between sustained and pro re nata (PRN) dosing of ranibizumab.
• To evaluate ranibizumab's effect following prior bevacizumab therapy.

Main Methods:

• An open-label, prospective study was conducted.
• Thirty eyes with persistent DME after bevacizumab were included.
• Participants were randomized into sustained or PRN ranibizumab dosing groups.

Main Results:

• Ranibizumab improved best-corrected visual acuity by an average of +6.5 ETDRS letters at 1 year.
• Central subfield thickness decreased by a mean of 116 µm at 1 year.
• Adverse events included two deaths and mild cataracts; one patient had multiple comorbidities.

Conclusions:

• 0.3 mg ranibizumab demonstrated efficacy in improving visual and anatomic outcomes for persistent DME.
• Ranibizumab offers a viable treatment option for patients with DME refractory to bevacizumab.
• Further investigation into safety profiles in specific patient populations is warranted.