title: Visual Impairment and Blindness Avoided with Ranibizumab in Hispanic and Non-Hispanic Whites with Diabetic Macular Edema in the United States.
abstract: OBJECTIVE
  To estimate visual impairment (VI) and blindness avoided with intravitreal ranibizumab 0.3 mg treatment for central-involved diabetic macular edema (DME) among Hispanic and non-Hispanic white individuals in the United States.
  
  
  METHODS
  Population-based model simulating visual acuity (VA) outcomes over 2 years after diagnosis and treatment of DME.
  
  
  METHODS
  Visual acuity changes with and without ranibizumab were based on data from the RISE, RIDE, and DRCR Network trials.
  
  
  METHODS
  For the better-seeing eye, VA outcomes included VI, defined as worse than 20/40 in the better-seeing eye, and blindness, defined as VA of 20/200 or worse in the better-seeing eye. Incidence of 1 or both eyes with central-involved DME in 2010 were estimated based on the 2010 United States population, prevalence of diabetes mellitus, and 1-year central-involved DME incidence rate. Sixty-one percent of incident individuals had bilateral DME and 39% had unilateral DME, but DME could develop in the fellow eye.
  
  
  METHODS
  Cases of VI and blindness avoided with ranibizumab treatment.
  
  
  RESULTS
  Among approximately 102 million Hispanic and non-Hispanic white individuals in the United States 45 years of age and older in 2010, an estimated 37 274 had central-involved DME and VI eligible for ranibizumab treatment. Compared with no ranibizumab treatment, the model predicted that ranibizumab 0.3 mg every 4 weeks would reduce the number of individuals with VI from 11 438 (95% simulation interval [SI], 7249-16 077) to 6304 (95% SI, 3921-8981), a 45% (95% SI, 36%-53%) reduction at 2 years. Ranibizumab would reduce the number of incident eyes with VA worse than 20/40 from 16 910 (95% SI, 10 729-23 577) to 9361 (95% SI, 5839-13 245), a 45% (95% SI, 38%-51%) reduction. Ranibizumab was estimated to reduce the number of individuals with legal blindness by 75% (95% SI, 58%-88%) and the number of incident eyes with VA of 20/200 or worse by 76% (95% SI, 63%-87%).
  
  
  CONCLUSIONS
  This model suggests that ranibizumab 0.3 mg every 4 weeks substantially reduces prevalence of VI and legal blindness 2 years after initiating treatment among Hispanic and non-Hispanic white individuals in the United States with central-involved DME that has caused vision loss.
authors: USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: rvarma@usc.edu.
authors: Rohit
authors: R
authors: Varma
authors: Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors: Neil M
authors: NM
authors: Bressler
authors: Outcomes Insights, Inc, Westlake Village, California.
authors: Quan V
authors: QV
authors: Doan
authors: Outcomes Insights, Inc, Westlake Village, California.
authors: Mark
authors: M
authors: Danese
authors: Genentech, Inc, South San Francisco, California.
authors: Chantal M
authors: CM
authors: Dolan
authors: Outcomes Insights, Inc, Westlake Village, California.
authors: Abraham
authors: A
authors: Lee
authors: Genentech, Inc, South San Francisco, California.
authors: Adam
authors: A
authors: Turpcu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001766:Blindness / Q000208:ethnology / Q000517:prevention & control*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D000069579:Ranibizumab; D014481:United States / Q000453:epidemiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D015354:Vision, Low / Q000208:ethnology / Q000517:prevention & control*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data; D044465:White People / Q000208:ethnology*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab