Comparison of efficacy of intravitreal ranibizumab between non-vitrectomized and vitrectomized eyes with diabetic macular edema.
OBJECTIVE
To compare the efficacy of intravitreal ranibizumab between non-vitrectomized and vitrectomized eyes with diabetic macular edema (DME).


METHODS
A retrospective, nonrandomized, and comparative study.


METHODS
From May 2013 to March 2016, 148 eyes of 148 patients with treatment-naïve center-involving DME were reviewed in one institution. Forty-six eyes underwent prior vitrectomy at least 3 months ago, and 102 eyes did not receive any vitrectomy. Three monthly then PRN intravitreal ranibizumab treatments were performed in all the patients with monthly follow-up for 6 months. Primary outcome measures included change in central foveal thickness (CFT) and best-corrected visual acuity (BCVA) at month 6.


RESULTS
The CFT significantly reduced, and the BCVA significantly improved 6 months after ranibizumab injections in either vitrectomized or non-vitrectomized groups (p < 0.05). There was no difference between vitrectomized and non-vitrectomized eyes in baseline characteristics. Significantly better final BCVA and visual gain were found in non-vitrectomized eyes than in vitrectomized eyes (p = 0.01 and 0.03, respectively). Final CFT and CFT decrease were significantly greater in non-vitrectomized group than in vitrectomized group (p = 0.02 and 0.006, respectively). Injection number of ranibizumab was 4.12 ± 0.58 in non-vitrectomized eyes, significantly less than that in vitrectomized eyes (5.05 ± 0.71) during 6-month period (p < 0.001). There were no severe systemic/ocular adverse effects in both groups.


CONCLUSIONS
Intravitreal ranibizumab was helpful for either vitrectomized or non-vitrectomized eyes with DME in short-term follow-up. Anatomical and functional improvements were greater in non-vitrectomized patients than in vitrectomized cases.
Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sect. 2, Nan-Ya South Road, Pan-Chiao District, New Taipei, 220, Taiwan.
Yen-Yi
YY
Chen
Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sect. 2, Nan-Ya South Road, Pan-Chiao District, New Taipei, 220, Taiwan.|Department of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
Pei-Ying
PY
Chen
Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sect. 2, Nan-Ya South Road, Pan-Chiao District, New Taipei, 220, Taiwan.|Department of Medicine, National Taiwan University, Taipei, Taiwan.
Fang-Ting
FT
Chen
Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sect. 2, Nan-Ya South Road, Pan-Chiao District, New Taipei, 220, Taiwan.|Department of Medicine, National Taiwan University, Taipei, Taiwan.
Yun-Ju
YJ
Chen
Department of Ophthalmology, Far Eastern Memorial Hospital, No. 21, Sect. 2, Nan-Ya South Road, Pan-Chiao District, New Taipei, 220, Taiwan. jiakangw2158@gmail.com.|Department of Medicine, National Taiwan University, Taipei, Taiwan. jiakangw2158@gmail.com.|Department of Medicine, National Yang Ming University, Taipei, Taiwan. jiakangw2158@gmail.com.|Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan. jiakangw2158@gmail.com.|Department of Healthcare Administration and Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan. jiakangw2158@gmail.com.
Jia-Kang
JK
Wang
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D003920:Diabetes Mellitus; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D020533:Angiogenesis Inhibitors; D000069579:Ranibizumab
Diabetic macular edema; Intravitreal injection; Ranibizumab; Vitrectomized eyes