Predictor of Early Remission of Diabetic Macular Edema under As-Needed Intravitreal Ranibizumab

The early remission of diabetic macular edema (DME) often occurs in eyes treated with anti-vascular endothelial growth factor (VEGF) treatment. We retrospectively reviewed and characterized eyes with early remission of DME at six months in 80 eyes under pro re nata (PRN) intravitreal ranibizumab (IVR) injections. The number of eyes without center-involved DME gradually increased and 14 and 20 eyes achieved remission of DME at 3 or 6 months, respectively, under the PRN regimen following three monthly loading doses. In particular, eyes with early remission at 6 months had smaller CSF thickness than those without the remission before and after the treatment except at the 1-month visit (P < 0.05); however, the changes in CSF thickness did not differ between them. VA and its changes were not different between eyes with and without remission. Multivariate analysis revealed that smaller CSF thickness at baseline predicted the early remission of DME under PRN IVR injections (odds ratio, 0.989; 95% confidence interval, 0.982–0.997; P = 0.008). These data elucidate the clinical characteristics of early remission of DME under PRN IVR injections and suggest that smaller CSF thickness at baseline is a novel predictor of early remission under PRN IVR injections for DME.