Real-life experience of ranibizumab for diabetic macular edema in Taiwan
Purpose To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan. Methods A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseli...
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| Veröffentlicht in: | International ophthalmology 2019-07, Vol.39 (7), p.1511-1522 |
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| creator | Tsai, Meng-Ju Hsieh, Yi-Ting Peng, Yi-Jie |
| description | Purpose
To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan.
Methods
A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseline vision between 20 and 70 ETDRS letters and a minimum central macular thickness (CMT) of 300 µm, had at least 3 monthly loading injections of ranibizumab in a year. Macular laser or posterior subtenon injections of triamcinolone acetonide (PSTA) could be performed as supplementary treatments following loading injections. Primary outcomes include best-corrected visual acuity and CMT.
Results
Patients’ vision improved from 46.5 ± 15.3 letters at baseline to 51.4 ± 16.6 letters at 12 months (
p
= 0.031). Mean CMT at baseline was 406 ± 105 µm, which decreased to 329 ± 108 µm (
p
= 0.002). At 12 months, 44.4% of eyes with total injection number 0.05). The average number of injections was 4.3 ± 1.0.
Conclusion
Treatment for DME with at least three monthly ranibizumab loading injections, with or without other supplementary treatments, is effective at 12 months thereafter. Two monthly reinjections of ranibizumab, while not significantly increasing vision, may have a role in preventing visual loss. |
| doi_str_mv | 10.1007/s10792-018-0970-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2057870635</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2057291908</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-92095045781db1ef9da5fdc2ea6a61971e123998adbb3569d34f178dd2cdf8343</originalsourceid><addsrcrecordid>eNp1kMtKBDEQRYMoOj4-wI0E3LiJVpLpTmcpoo4gCDKuQ7pTkQz9GJNpfHy90fEBgqta1Lm3ikPIIYdTDqDOEgelBQNeMdAKmNogE14oyUQpYZNMgJcFKxTwHbKb0gIgU7rcJjtC64yU0wmZ3aNtWRs8UnxZYgzYN0gHT6PtQx3exs7W1A-RumBrXIWGdrYZWxspOuwsDT2d2_Bs-32y5W2b8OBr7pGHq8v5xYzd3l3fXJzfskYqsWJagC5gWqiKu5qj184W3jUCbWlLrhVHLqTWlXV1LYtSOzn1XFXOicb5Sk7lHjlZ9y7j8DRiWpkupAbb1vY4jMkIyN0KSllk9PgPuhjG2OfvPimhuYYqU3xNNXFIKaI3yxg6G18NB_Oh2aw1m6zZfGg2KmeOvprHukP3k_j2mgGxBlJe9Y8Yf0__3_oOEFCGYw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2057291908</pqid></control><display><type>article</type><title>Real-life experience of ranibizumab for diabetic macular edema in Taiwan</title><source>SpringerLink Journals - AutoHoldings</source><creator>Tsai, Meng-Ju ; Hsieh, Yi-Ting ; Peng, Yi-Jie</creator><creatorcontrib>Tsai, Meng-Ju ; Hsieh, Yi-Ting ; Peng, Yi-Jie</creatorcontrib><description>Purpose
To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan.
Methods
A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseline vision between 20 and 70 ETDRS letters and a minimum central macular thickness (CMT) of 300 µm, had at least 3 monthly loading injections of ranibizumab in a year. Macular laser or posterior subtenon injections of triamcinolone acetonide (PSTA) could be performed as supplementary treatments following loading injections. Primary outcomes include best-corrected visual acuity and CMT.
Results
Patients’ vision improved from 46.5 ± 15.3 letters at baseline to 51.4 ± 16.6 letters at 12 months (
p
= 0.031). Mean CMT at baseline was 406 ± 105 µm, which decreased to 329 ± 108 µm (
p
= 0.002). At 12 months, 44.4% of eyes with total injection number < 5 and 42.9% with injection number ≥ 5 achieved a gain in vision that was 10 letters or more. A total of 5 injections or more did not lead to a better visual gain in comparison with only 3–4 injections (
p
= 0.71), and both had similar number of supplementary treatments (
p
= 0.43). Monthly reinjections of ranibizumab resulted in a lower likelihood of visual loss of 10 or 15 letters (
p
= 0.019 and 0.015, respectively, adjusted for age, baseline vision, severity of diabetic retinopathy and the presence of previous treatments); however, supplementary macular lasers, PSTA or ranibizumab without monthly reinjections did not (all
p
> 0.05). The average number of injections was 4.3 ± 1.0.
Conclusion
Treatment for DME with at least three monthly ranibizumab loading injections, with or without other supplementary treatments, is effective at 12 months thereafter. Two monthly reinjections of ranibizumab, while not significantly increasing vision, may have a role in preventing visual loss.</description><identifier>ISSN: 0165-5701</identifier><identifier>EISSN: 1573-2630</identifier><identifier>DOI: 10.1007/s10792-018-0970-7</identifier><identifier>PMID: 29926364</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Acuity ; Diabetes ; Diabetes mellitus ; Diabetic retinopathy ; Edema ; Eye ; Eye (anatomy) ; Health care ; Immunotherapy ; Injection ; Lasers ; Medicine ; Medicine & Public Health ; Monoclonal antibodies ; Ophthalmology ; Original Paper ; Patients ; Retinopathy ; Triamcinolone acetonide ; Vision ; Visual acuity</subject><ispartof>International ophthalmology, 2019-07, Vol.39 (7), p.1511-1522</ispartof><rights>Springer Nature B.V. 2018</rights><rights>International Ophthalmology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-92095045781db1ef9da5fdc2ea6a61971e123998adbb3569d34f178dd2cdf8343</citedby><cites>FETCH-LOGICAL-c372t-92095045781db1ef9da5fdc2ea6a61971e123998adbb3569d34f178dd2cdf8343</cites><orcidid>0000-0003-4593-3210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10792-018-0970-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10792-018-0970-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29926364$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsai, Meng-Ju</creatorcontrib><creatorcontrib>Hsieh, Yi-Ting</creatorcontrib><creatorcontrib>Peng, Yi-Jie</creatorcontrib><title>Real-life experience of ranibizumab for diabetic macular edema in Taiwan</title><title>International ophthalmology</title><addtitle>Int Ophthalmol</addtitle><addtitle>Int Ophthalmol</addtitle><description>Purpose
To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan.
Methods
A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseline vision between 20 and 70 ETDRS letters and a minimum central macular thickness (CMT) of 300 µm, had at least 3 monthly loading injections of ranibizumab in a year. Macular laser or posterior subtenon injections of triamcinolone acetonide (PSTA) could be performed as supplementary treatments following loading injections. Primary outcomes include best-corrected visual acuity and CMT.
Results
Patients’ vision improved from 46.5 ± 15.3 letters at baseline to 51.4 ± 16.6 letters at 12 months (
p
= 0.031). Mean CMT at baseline was 406 ± 105 µm, which decreased to 329 ± 108 µm (
p
= 0.002). At 12 months, 44.4% of eyes with total injection number < 5 and 42.9% with injection number ≥ 5 achieved a gain in vision that was 10 letters or more. A total of 5 injections or more did not lead to a better visual gain in comparison with only 3–4 injections (
p
= 0.71), and both had similar number of supplementary treatments (
p
= 0.43). Monthly reinjections of ranibizumab resulted in a lower likelihood of visual loss of 10 or 15 letters (
p
= 0.019 and 0.015, respectively, adjusted for age, baseline vision, severity of diabetic retinopathy and the presence of previous treatments); however, supplementary macular lasers, PSTA or ranibizumab without monthly reinjections did not (all
p
> 0.05). The average number of injections was 4.3 ± 1.0.
Conclusion
Treatment for DME with at least three monthly ranibizumab loading injections, with or without other supplementary treatments, is effective at 12 months thereafter. Two monthly reinjections of ranibizumab, while not significantly increasing vision, may have a role in preventing visual loss.</description><subject>Acuity</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic retinopathy</subject><subject>Edema</subject><subject>Eye</subject><subject>Eye (anatomy)</subject><subject>Health care</subject><subject>Immunotherapy</subject><subject>Injection</subject><subject>Lasers</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monoclonal antibodies</subject><subject>Ophthalmology</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Retinopathy</subject><subject>Triamcinolone acetonide</subject><subject>Vision</subject><subject>Visual acuity</subject><issn>0165-5701</issn><issn>1573-2630</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKBDEQRYMoOj4-wI0E3LiJVpLpTmcpoo4gCDKuQ7pTkQz9GJNpfHy90fEBgqta1Lm3ikPIIYdTDqDOEgelBQNeMdAKmNogE14oyUQpYZNMgJcFKxTwHbKb0gIgU7rcJjtC64yU0wmZ3aNtWRs8UnxZYgzYN0gHT6PtQx3exs7W1A-RumBrXIWGdrYZWxspOuwsDT2d2_Bs-32y5W2b8OBr7pGHq8v5xYzd3l3fXJzfskYqsWJagC5gWqiKu5qj184W3jUCbWlLrhVHLqTWlXV1LYtSOzn1XFXOicb5Sk7lHjlZ9y7j8DRiWpkupAbb1vY4jMkIyN0KSllk9PgPuhjG2OfvPimhuYYqU3xNNXFIKaI3yxg6G18NB_Oh2aw1m6zZfGg2KmeOvprHukP3k_j2mgGxBlJe9Y8Yf0__3_oOEFCGYw</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Tsai, Meng-Ju</creator><creator>Hsieh, Yi-Ting</creator><creator>Peng, Yi-Jie</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4593-3210</orcidid></search><sort><creationdate>20190701</creationdate><title>Real-life experience of ranibizumab for diabetic macular edema in Taiwan</title><author>Tsai, Meng-Ju ; Hsieh, Yi-Ting ; Peng, Yi-Jie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-92095045781db1ef9da5fdc2ea6a61971e123998adbb3569d34f178dd2cdf8343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acuity</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetic retinopathy</topic><topic>Edema</topic><topic>Eye</topic><topic>Eye (anatomy)</topic><topic>Health care</topic><topic>Immunotherapy</topic><topic>Injection</topic><topic>Lasers</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monoclonal antibodies</topic><topic>Ophthalmology</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Retinopathy</topic><topic>Triamcinolone acetonide</topic><topic>Vision</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsai, Meng-Ju</creatorcontrib><creatorcontrib>Hsieh, Yi-Ting</creatorcontrib><creatorcontrib>Peng, Yi-Jie</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsai, Meng-Ju</au><au>Hsieh, Yi-Ting</au><au>Peng, Yi-Jie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real-life experience of ranibizumab for diabetic macular edema in Taiwan</atitle><jtitle>International ophthalmology</jtitle><stitle>Int Ophthalmol</stitle><addtitle>Int Ophthalmol</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>39</volume><issue>7</issue><spage>1511</spage><epage>1522</epage><pages>1511-1522</pages><issn>0165-5701</issn><eissn>1573-2630</eissn><abstract>Purpose
To evaluate the visual and anatomical outcomes of intravitreal ranibizumab for diabetic macular edema (DME) in the healthcare system of Taiwan.
Methods
A total of 39 eyes from 39 patients were retrospectively enrolled in the study. All eyes that fulfilled the key criteria, including a baseline vision between 20 and 70 ETDRS letters and a minimum central macular thickness (CMT) of 300 µm, had at least 3 monthly loading injections of ranibizumab in a year. Macular laser or posterior subtenon injections of triamcinolone acetonide (PSTA) could be performed as supplementary treatments following loading injections. Primary outcomes include best-corrected visual acuity and CMT.
Results
Patients’ vision improved from 46.5 ± 15.3 letters at baseline to 51.4 ± 16.6 letters at 12 months (
p
= 0.031). Mean CMT at baseline was 406 ± 105 µm, which decreased to 329 ± 108 µm (
p
= 0.002). At 12 months, 44.4% of eyes with total injection number < 5 and 42.9% with injection number ≥ 5 achieved a gain in vision that was 10 letters or more. A total of 5 injections or more did not lead to a better visual gain in comparison with only 3–4 injections (
p
= 0.71), and both had similar number of supplementary treatments (
p
= 0.43). Monthly reinjections of ranibizumab resulted in a lower likelihood of visual loss of 10 or 15 letters (
p
= 0.019 and 0.015, respectively, adjusted for age, baseline vision, severity of diabetic retinopathy and the presence of previous treatments); however, supplementary macular lasers, PSTA or ranibizumab without monthly reinjections did not (all
p
> 0.05). The average number of injections was 4.3 ± 1.0.
Conclusion
Treatment for DME with at least three monthly ranibizumab loading injections, with or without other supplementary treatments, is effective at 12 months thereafter. Two monthly reinjections of ranibizumab, while not significantly increasing vision, may have a role in preventing visual loss.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>29926364</pmid><doi>10.1007/s10792-018-0970-7</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4593-3210</orcidid></addata></record> |
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| ispartof | International ophthalmology, 2019-07, Vol.39 (7), p.1511-1522 |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Acuity Diabetes Diabetes mellitus Diabetic retinopathy Edema Eye Eye (anatomy) Health care Immunotherapy Injection Lasers Medicine Medicine & Public Health Monoclonal antibodies Ophthalmology Original Paper Patients Retinopathy Triamcinolone acetonide Vision Visual acuity |
| title | Real-life experience of ranibizumab for diabetic macular edema in Taiwan |
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