title: Symmetry in early response to intravitreal ranibizumab in bilateral diabetic macular oedema.
abstract: OBJECTIVE
  To study the symmetry in response to bilateral diabetic macular oedema (DME) treated with bilateral intravitreal injections of ranibizumab (IVR).
  
  
  METHODS
  The charts of 36 eyes of 18 patients treated with a loading dose of three monthly IVR in both eyes were retrospectively reviewed. Favourable anatomical response was defined as a decrease by more than 10% in baseline central macular thickness (CMT), and favourable functional response was defined as an increase in visual acuity (VA) ≥5 letters. A symmetric response was defined as a similar anatomical and/or functional response in the first (FE) and second (SE) treated eyes.
  
  
  RESULTS
  The VA improved significantly after ranibizumab treatment in both eyes (p < 0.01). A statistically significant positive correlation was found for the functional response to ranibizumab between the FE and the SE (R(2)  = 0.26, p = 0.03). The mean CMT decreased significantly in both eyes (p < 0.01). A strong positive correlation was observed between the anatomical response to ranibizumab in the FE and the SE (R(2)  = 0.37, p = 0.01). Symmetric favourable anatomical and functional responses were observed in 13 patients (72%). In two additional patients, an asymmetric functional response was observed despite a decrease in retinal thickness in both eyes.
  
  
  CONCLUSIONS
  Symmetric anatomical and functional responses were observed in 72% of patients with DME after three initial IVR in each eye. This finding could be of clinical interest in the decision to treat the fellow eye, in a disease where a bilateral involvement is frequent.
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Margaux
authors.initials: M
authors.lastname: Guillard
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Dupas
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sanharawi
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Ali
authors.initials: A
authors.lastname: Erginay
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
authors.affiliation: AP-HP, Lariboisiere Hospital, Department of Ophthalmology, Paris-Diderot University, Sorbonne Paris Cité, Paris, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Massin
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
keywords: diabetic macular oedema; ranibizumab; response; symmetry