title: Intravitreal ranibizumab for diabetic macular oedema in previously vitrectomized eyes.
abstract: OBJECTIVE
  There is little information about the efficacy of intravitreal vascular endothelial growth factor (VEGF) inhibition in vitrectomized eyes. This study aimed to evaluate the efficacy of anti-VEGF (ranibizumab) on diabetic macular oedema in previously vitrectomized eyes.
  
  
  METHODS
  A nationwide retrospective review of medical records from 2010 to 2013.
  
  
  RESULTS
  We identified 33 previously vitrectomized eyes in 28 patients treated with ranibizumab injections for diabetic macular oedema. Median follow-up was 323 days (interquartile range 72-1404 days). Baseline mean visual acuity was 0.57 logMAR (95% CI 0.13-1.01) before injections. After an average of 4.7 injections (range 1-15), mean visual acuity remained stable at 0.54 logMAR (95% CI 0.13-0.95) with a mean improvement of 0.03 (p = 0. 45, 95% CI -0.12 to 0.06). In 12 eyes (36%), visual acuity improved 0.1 logMAR or more, in 12 eyes (36%), vision was unchanged (gain or loss of 0-0.05 logMAR), and in nine eyes (27%), vision decreased 0.1 logMAR or more. Mean central foveal thickness (CFT) on optical coherence tomography (OCT) scan was 412 μm (95% CI 390-434 μm) before injections. After injections, the mean CFT decreased to 352 μm (95% CI 334-370 μm). The mean reduction in CFT was 14% (95% CI 4-24%, p = 0.01). Sixteen eyes (48.5%) became devoid of oedema on the last OCT scan. Despite the significant reduction in CFT, the visual acuity remained unchanged.
  
  
  CONCLUSIONS
  Intravitreal ranibizumab can be effective in previously vitrectomized eyes with diabetic macular oedema. However, the response is variable and should be carefully monitored.
authors.affiliation: Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
authors.forename: Caroline Schmidt
authors.initials: CS
authors.lastname: Laugesen
authors.affiliation: Department of Ophthalmology, Rigshospitalet - Glostrup Hospital, Glostrup, Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Ostri
authors.affiliation: Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Brynskov
authors.affiliation: Department of Ophthalmology, Rigshospitalet - Glostrup Hospital, Glostrup, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Lund-Andersen
authors.affiliation: Department of Ophthalmology, Rigshospitalet - Glostrup Hospital, Glostrup, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Larsen
authors.affiliation: Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Vorum
authors.affiliation: Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Torben L
authors.initials: TL
authors.lastname: Sørensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab
keywords: anti-VEGF; diabetic macular oedema; ranibizumab; vitrectomy