Visual Outcomes Following Intravitreal Ranibizumab for Diabetic Macular Edema in a Pro Re Nata Protocol from...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacological Treatments

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Intravitreal ranibizumab is a common treatment for DME.
• The optimal treatment protocol, particularly regarding initial dosing, requires further investigation.

Purpose of the Study:

• To evaluate the long-term effectiveness of a pro re nata (PRN) ranibizumab treatment protocol for DME.
• To assess outcomes when PRN treatment is initiated from the first month without mandatory loading doses.
• To compare visual acuity changes based on the number of injections received in the first three months.

Main Methods:

• Retrospective interventional study analyzing 180 eyes of 144 patients with treatment-naive DME.
• Patients received intravitreal ranibizumab with a minimum 1-year follow-up.
• Primary outcome: change in best-corrected visual acuity (BCVA) from baseline at 1-year follow-up.

Main Results:

• Mean BCVA improved from baseline (0.47 logMAR) to 3 months (0.38 logMAR) and stabilized at 1 year (0.35 logMAR) and 2 years (0.34 logMAR).
• At 3 months, 13% received 1 injection, 29% received 2, and 58% received 3 injections.
• Eyes receiving fewer injections in the first 3 months required fewer overall injections and follow-up visits.

Conclusions:

• Approximately one-third of DME eyes responded well to a PRN ranibizumab strategy initiated without loading doses.
• Baseline visual acuity is a significant predictor of visual outcomes at 1 and 2 years post-treatment.
• This PRN approach may offer a more personalized and potentially less intensive treatment regimen for DME.