Cargando…

Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area

PURPOSE: To analyze the effects on microaneurysm (MA) and perifoveal perfusion in nonproliferative diabetic retinopathy (NPDR) patients with macular edema (ME) after early intensive treatment using intravitreal ranibizumab (IVR) injections. PATIENTS AND METHODS: Prospectively, 25 eyes of 25 type 2 d...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Seung Joon, Shin, In Choel, Jeong, Il Won, Choi, Chang Wook, Yang, Yun Sik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305822/
https://www.ncbi.nlm.nih.gov/pubmed/32606576
http://dx.doi.org/10.2147/OPTH.S248529
_version_ 1783548541703028736
author Lee, Seung Joon
Shin, In Choel
Jeong, Il Won
Choi, Chang Wook
Yang, Yun Sik
author_facet Lee, Seung Joon
Shin, In Choel
Jeong, Il Won
Choi, Chang Wook
Yang, Yun Sik
author_sort Lee, Seung Joon
collection PubMed
description PURPOSE: To analyze the effects on microaneurysm (MA) and perifoveal perfusion in nonproliferative diabetic retinopathy (NPDR) patients with macular edema (ME) after early intensive treatment using intravitreal ranibizumab (IVR) injections. PATIENTS AND METHODS: Prospectively, 25 eyes of 25 type 2 diabetes mellitus patients with ME were included between August 2016 and February 2019. For 6 months, patients were administered 0.5-mg IVR injections monthly. Ocular evaluation, including best-corrected visual acuity (BCVA; using the Early Treatment Diabetic Retinopathy Study chart), central retinal thickness (CRT; using optical coherence tomography), fundus photography, and fluorescein angiography, was performed for all participants. Results obtained at baseline were compared to those observed after 6 months. RESULTS: Mean BCVA increased significantly from 67.6±3.29 letters at baseline to 76.36±1.61 letters after 6 months (P=0.002) of IVR therapy. CRT decreased significantly from 479.12±16.66 µm at baseline to 369.12±13.02 µm at 6 months. Similarly, the total number of MAs decreased significantly from 5.68±3.41 to 1.60±1.73 (P<0.0001). MA turnover, calculated by adding the MA formation rate to the MA disappearance rate (both calculated as MA number/month) also decreased significantly from 6.88±3.83 to 1.92±1.75 after treatment (P<0.0001). Perifoveal non-perfused area decreased from 2.517±0.456 mm(2) at baseline to 2.495±0.293 mm(2) at 6 months, but the results were not statistically significant (P=0.954). CONCLUSION: Treatment with early intensive IVR therapy in NPDR patients with ME not only improved BCVA and CRT but also decreased MA turnover. However, in the study period of 6 months, IVR therapy did not show significant improvement in perifoveal non-perfused area.
format Online
Article
Text
id pubmed-7305822
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-73058222020-06-29 Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area Lee, Seung Joon Shin, In Choel Jeong, Il Won Choi, Chang Wook Yang, Yun Sik Clin Ophthalmol Original Research PURPOSE: To analyze the effects on microaneurysm (MA) and perifoveal perfusion in nonproliferative diabetic retinopathy (NPDR) patients with macular edema (ME) after early intensive treatment using intravitreal ranibizumab (IVR) injections. PATIENTS AND METHODS: Prospectively, 25 eyes of 25 type 2 diabetes mellitus patients with ME were included between August 2016 and February 2019. For 6 months, patients were administered 0.5-mg IVR injections monthly. Ocular evaluation, including best-corrected visual acuity (BCVA; using the Early Treatment Diabetic Retinopathy Study chart), central retinal thickness (CRT; using optical coherence tomography), fundus photography, and fluorescein angiography, was performed for all participants. Results obtained at baseline were compared to those observed after 6 months. RESULTS: Mean BCVA increased significantly from 67.6±3.29 letters at baseline to 76.36±1.61 letters after 6 months (P=0.002) of IVR therapy. CRT decreased significantly from 479.12±16.66 µm at baseline to 369.12±13.02 µm at 6 months. Similarly, the total number of MAs decreased significantly from 5.68±3.41 to 1.60±1.73 (P<0.0001). MA turnover, calculated by adding the MA formation rate to the MA disappearance rate (both calculated as MA number/month) also decreased significantly from 6.88±3.83 to 1.92±1.75 after treatment (P<0.0001). Perifoveal non-perfused area decreased from 2.517±0.456 mm(2) at baseline to 2.495±0.293 mm(2) at 6 months, but the results were not statistically significant (P=0.954). CONCLUSION: Treatment with early intensive IVR therapy in NPDR patients with ME not only improved BCVA and CRT but also decreased MA turnover. However, in the study period of 6 months, IVR therapy did not show significant improvement in perifoveal non-perfused area. Dove 2020-06-16 /pmc/articles/PMC7305822/ /pubmed/32606576 http://dx.doi.org/10.2147/OPTH.S248529 Text en © 2020 Lee et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Lee, Seung Joon
Shin, In Choel
Jeong, Il Won
Choi, Chang Wook
Yang, Yun Sik
Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title_full Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title_fullStr Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title_full_unstemmed Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title_short Prospective, Single-Center, Six-Month Study of Intravitreal Ranibizumab for Macular Edema with Nonproliferative Diabetic Retinopathy: Effects on Microaneurysm Turnover and Non-Perfused Retinal Area
title_sort prospective, single-center, six-month study of intravitreal ranibizumab for macular edema with nonproliferative diabetic retinopathy: effects on microaneurysm turnover and non-perfused retinal area
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305822/
https://www.ncbi.nlm.nih.gov/pubmed/32606576
http://dx.doi.org/10.2147/OPTH.S248529
work_keys_str_mv AT leeseungjoon prospectivesinglecentersixmonthstudyofintravitrealranibizumabformacularedemawithnonproliferativediabeticretinopathyeffectsonmicroaneurysmturnoverandnonperfusedretinalarea
AT shininchoel prospectivesinglecentersixmonthstudyofintravitrealranibizumabformacularedemawithnonproliferativediabeticretinopathyeffectsonmicroaneurysmturnoverandnonperfusedretinalarea
AT jeongilwon prospectivesinglecentersixmonthstudyofintravitrealranibizumabformacularedemawithnonproliferativediabeticretinopathyeffectsonmicroaneurysmturnoverandnonperfusedretinalarea
AT choichangwook prospectivesinglecentersixmonthstudyofintravitrealranibizumabformacularedemawithnonproliferativediabeticretinopathyeffectsonmicroaneurysmturnoverandnonperfusedretinalarea
AT yangyunsik prospectivesinglecentersixmonthstudyofintravitrealranibizumabformacularedemawithnonproliferativediabeticretinopathyeffectsonmicroaneurysmturnoverandnonperfusedretinalarea