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Home All Specialties Chronic Disease

Diabetic patients report improved vision after ranibizumab treatment

byAndrew Bishara
August 23, 2013
in Chronic Disease, Ophthalmology
Reading Time: 3 mins read
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Image: PD Diabetic Macular Edema

1. Mean patient-reported visual improvement scores increased with ranibizumab monotherapy and ranibizumab + laser with an increase of 5.0 and 5.4 points respectively compared to the 0.6-point increase in the laser-only treatment (p<0.05). 

2. 49.1% of patients undergoing ranibizumab therapy achieved a 5-point improvement, compared to 42.2% of the ranibizumab monotherapy group and 30.6% of the laser-only group.

Evidence Rating Level: 1 (Excellent) 

Study Rundown: This study is important in demonstrating that ranibizumab treatment has a positive effect on vision in patients with diabetic macular edema. Given today’s focus on outcome-based guidelines, this study is essential in demonstrating that diabetic patients experience an improvement in their vision after treatment with ranibizumab. The study provides crucial corroboration to the RESTORE trial, a previous study that demonstrated a significant improvement in measured visual acuity after ranibizumab treatment. Even without laser treatment, ranibizumab has a tremendous impact on vision. Strengths of this study include the fact that the study had a large database of patients throughout the world and that a standardized scoring system was utilized. Limitations include that the study was only carried out to 12 months, while the RESTORE trial lasted for 3 years. Thus, it is difficult to ascertain whether the increase in patient-perceived visual acuity remains after the first year.

Click to read the study in JAMA Ophthalmology

Relevant Reading: The RESTORE Study: Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

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In-Depth [randomized study]: This study attempted to obtain patient-reported visual outcome improvements with the use of ranibizumab for diabetic macular edema, a cause of visual impairment among diabetic patients. The study utilized National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) to receive an objective report of visual functioning per the patient. An improvement of 4-6 points reflects a clinically relevant increase in visual acuity of at least 15 letters. Diabetic patients with reduced vision due to macular edema were randomly assigned to one of three groups – ranibizumab + sham laser, ranibizumab + laser, or sham injection + laser. Injections were administered monthly, while laser was utilized as needed. Mean composite scores increased with ranibizumab monotherapy and ranibizumab + laser with an increase of 5.0 and 5.4 points respectively (p<0.05). These effects lasted from the 3-month time point to the 12-month time point. 49.1% of patients undergoing ranibizumab therapy achieved a 5-point improvement, compared to 42.2% of the ranibizumab monotherapy group and 30.6% of the laser only group. There was no difference if the eye that was treated was the better or worse eye. Regression analysis demonstrated that treatment with ranibizumab was a strong predictor of higher scores.

By Swarup Swaminathan and Andrew Bishara

More from this author: Argus II retinal prosthesis significantly improves spatial vision in blind patients, Artificial cornea is well retained in patients with ocular surface disease, High prevalence of undiagnosed glaucoma in West Africa, Interferon therapy is superior to methotrexate for uveitis, Rho kinase inhibitor safely reduces intraocular pressure 

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Tags: diabetic macular edemalasersOphthalmologyranibizumabRESTORE trialvisual improvement scores
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