title: Effect of macular ischemia on intravitreal ranibizumab treatment for diabetic macular edema.
abstract: OBJECTIVE
  To evaluate the impact of macular ischemia on the functional and anatomical outcome after intravitreal injections of ranibizumab for the treatment of diabetic macular edema (DME).
  
  
  METHODS
  Participants were 49 patients with diabetes mellitus, divided into two groups based on the presence of ischemia on fluorescein angiography: (i) nonischemic group (n = 32) and (ii) ischemic group (n = 17). All patients were treated with intravitreal ranibizumab and were followed up for 6 months. The main outcome measures were changes in visual acuity (VA) and central foveal thickness (CFT).
  
  
  RESULTS
  There was a statistically significant improvement in VA and CFT between baseline and the end of the follow-up in the nonischemic group, while in the ischemic group there was no significant difference in VA but CFT differed significantly at the 6-month follow-up.
  
  
  CONCLUSIONS
  Macular ischemia may have a negative impact on functional outcomes 6 months after intravitreal ranibizumab treatment in patients with DME but has no effect on anatomical outcomes.
authors.affiliation: 2nd Department of Ophthalmology, Attikon Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Douvali
authors.forename: Irini P
authors.initials: IP
authors.lastname: Chatziralli
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Theodossiadis
authors.forename: Klio I
authors.initials: KI
authors.lastname: Chatzistefanou
authors.forename: Emmanouella
authors.initials: E
authors.lastname: Giannakaki
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Rouvas
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D007511:Ischemia / Q000503:physiopathology*; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012160:Retina / Q000473:pathology; D012171:Retinal Vessels / Q000502:physiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab