title: Residual edema evaluation with ranibizumab 0.5 mg and 2.0 mg formulations for diabetic macular edema (REEF study).
abstract: OBJECTIVE
  To compare the efficacy of ranibizumab 0.5-mg and 2.0-mg intravitreal injections for persistent diabetic macular edema (DME) previously treated with bevacizumab.
  
  
  METHODS
  In all, 43 patients with residual center-involved DME following intravitreal bevacizumab were included in this 12-month prospective, nonrandomized, multicenter study. Enrolled patients received three monthly ranibizumab 0.5-mg injections. At month 3, patients with residual macular edema switched to three monthly injections of ranibizumab 2.0-mg. Assessments included monthly visual acuity and spectral-domain optical coherence tomography.
  
  
  RESULTS
  Mean visual acuity improved by +6.4 letters at month 3 and +8.8 letters at month 6. Mean central subfield thickness (CST) decreased by -113 μm at month 3 and -165 μm at month 6. Before enrollment, 29/43 (67.4%) patients showed <10% CST reduction following monthly bevacizumab treatment. After three monthly ranibizumab 0.5-mg injections, 22/29 (75.9%) patients showed >10% reduction in CST, whereas 6 showed <10% reduction. Of these six, three (50%) showed >10% reduction in CST after switching to three monthly ranibizumab 2.0-mg doses. No serious adverse events were observed to month 6.
  
  
  CONCLUSIONS
  Ranibizumab 0.5-mg or 2.0-mg may improve visual and anatomic outcomes in patients with DME who demonstrated minimal or no response to bevacizumab therapy. Moreover, increased dosage of ranibizumab (2.0-mg) may provide additional benefit over ranibizumab 0.5-mg in some patients. However, 2.0-mg ranibizumab is not currently commercially licensed or available.
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: D S
authors: DS
authors: Dhoot
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: D J
authors: DJ
authors: Pieramici
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: M
authors: M
authors: Nasir
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: A A
authors: AA
authors: Castellarin
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: S
authors: S
authors: Couvillion
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: R F
authors: RF
authors: See
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: N
authors: N
authors: Steinle
authors: Hawaii Retina Institute, Honolulu, HI, USA.
authors: M
authors: M
authors: Bennett
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: M
authors: M
authors: Rabena
authors: California Retina Consultants and Research Foundation, Santa Barbara, CA, USA.
authors: R L
authors: RL
authors: Avery
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D000069579:Ranibizumab / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab
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