title: [Improvement of fixation in diabetic macular oedema patients under intravitreal ranibizumab treatment].
abstract: BACKGROUND
  The aim of this study was to evaluate the fixation and other functional and morphological alterations in patients with diabetic macular oedema (DMO) under intravitreal ranibizumab therapy.
  
  
  METHODS
  Thirty patients (39 eyes) with DMO with central involvement were included in this prospective study. Morphological (fluorescein angiography, OCT) as well as functional (visual acuity, microperimetry including fixation) parameters were analysed before and after three monthly intravitreal applications of ranibizumab.
  
  
  RESULTS
  Best-corrected mean visual acuity (BCVA) increased significantly by 6.85 + 6.45 letters from 26.15 ± 13.83 to 33.03 ± 13.31 letters. Mean central retinal thickness and mean central retinal volume decreased significantly from 503.72 ± 143.78 µm, respectively (p < 0.001) before treatment to 387.05 ± 122.02 µm after the third intravitreal injection with ranibizumab. Mean retinal sensitivity obtained with microperimetry did not change significantly over the course of treatment. Mean fixation within 2° (4°) improved from 64.15 % (85.7 %) before treatment significantly to 70.15 % (91.5 %) after three intravitreal injections with ranibizumab. Mean fixation stability within 2° improved from 43.9 % before treatment significantly to 58.5 % after three intravitreal injections.
  
  
  CONCLUSIONS
  DMO improved both morphologically with a significant reduction of central retinal thickness and volume and a significantly improved BCVA as well as fixation and fixation stability over the course of three monthly intravitreal injections with ranibizumab. Retinal sensitivity obtained in microperimetry did not change significantly over the course. Based on our observations we interpret and suggest fixation and fixation stability as an early functional parameter and prior to microperimetrically detectable changes of retinal sensitivity additional to BCVA during treatment of diabetic macular edema.
authors.affiliation: Augenklinik, Ludwig-Maximilians-Universität München, Mathildenstrasse 8, Munich.
authors.forename: F
authors.initials: F
authors.lastname: Seidensticker
authors.forename: L
authors.initials: L
authors.lastname: Reznicek
authors.forename: S
authors.initials: S
authors.lastname: Cserhati
authors.forename: R G
authors.initials: RG
authors.lastname: Liegl
authors.forename: J
authors.initials: J
authors.lastname: Langer
authors.forename: A
authors.initials: A
authors.lastname: Wolf
authors.forename: A
authors.initials: A
authors.lastname: Kampik
authors.forename: M
authors.initials: M
authors.lastname: Ulbig
authors.forename: C
authors.initials: C
authors.lastname: Haritoglou
authors.forename: M
authors.initials: M
authors.lastname: Kernt
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D005403:Fixation, Ocular / Q000187:drug effects*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab