@article{f7d5c613ea4247d99b814d2f7560b36e,
title = "Factors affecting visual outcomes in patients with diabetic macular edema treated with ranibizumab",
abstract = "PurposeTo identify factors associated with visual outcomes in patients with diabetic macular edema (DME) treated with ranibizumab (RBZ) in the Ranibizumab for Edema of the mAcula in Diabetes - Protocol 2 (READ-2) Study.Patients and methodsOptical coherence tomography scans, fundus photographs, and fluorescein angiograms (FAs) were graded and along with baseline characteristics were correlated with month (M) 24 visual outcome of best-corrected visual acuity (BCVA) ≤20/100 (poor outcome) vs >20/100 (better outcome).ResultsOf 101 patients with a M20 visit or beyond, 27 (27%) had BCVA ≤20/100. Comparison of patients with or without poor outcome showed mean baseline BCVA of 16.8 letters (20/125) in the former compared with 30.4 letters (20/63; P<0.001). Mean change in BCVA between baseline and M24 was -2.6 letters in the poor outcome group compared with +9.8 letters (P<0.001). Foveal thickness (FTH) at M24 was 374.1 μm in the poor outcome group compared with 268.8 μm (P<0.01), a difference driven by 14 patients with mean FTH of 450.3 μm. Foveal atrophy occurred in 65% (11/17) in the poor outcome group compared with 17%(12/71, P=0.001). Persistent edema was noted in 52% (14/27) of patients with poor outcome. Laser scars near foveal center were significantly more common in patients with poor outcome who did not have edema vs those who did (78% (7/9) vs 23% (3/13) P=0.03).ConclusionPoor baseline BCVA (≤20/125) in DME patients predicts poor visual outcome (≤20/100) after 2 years of treatment with RBZ and/or focal/grid laser, often due to foveal atrophy and/or persistent edema.",
keywords = "Anti-VEGF, Diabetic macular edema, Macular edema, Ranibizumab",
author = "R. Channa and R. Sophie and Khwaja, {A. A.} and Do, {D. V.} and G. Hafiz and Nguyen, {Q. D.} and Campochiaro, {P. A.}",
note = "Funding Information: Jiangxia Wang, MS, MA, assisted with the data analysis for this study. She is affiliated with the Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health; supported by Wilmer Biostatistics Core Grant EY01765. The study was supported by Genentech and by a grant from the Juvenile Diabetes Research Foundation. Funding Information: Afsheen Khwaja was an employee of JHU during the conduct of the study, but is now an employee of Santen Inc. Diana V Do has the following potential conflicts of interest: consultant for ISTA and Johns Hopkins University has received payment for her consulting with Regeneron and Genentech. She has received an honorarium from Heidelberg. Johns Hopkins University, the previous employer of Dr Do receives research support from Genentech, Regeneron, Heidelberg, and Pfizer. Quan Dong Nguyen has the following potential conflicts of interest: consultant for Bausch and Lomb, and Santen. The Johns Hopkins University receives payment for his consulting with Genentech, Acucela, Pfizer, Regeneron, GlaxoSmithKline, and Heidelberg. Johns Hopkins University, the previous employer of Dr Nguyen, has received research support from Genentech, MacuSight, and Regeneron. Dr Nguyen chairs the Steering Committee for the RISE and RIDE studies. Peter A Campochiaro has the following potential conflicts of interest: consultant for Kala Pharmaceuticals and Applied Genetic Technologies Corporation and served as a consultant for Allergan within the past 2 years. Johns Hopkins University receives payment for his consultation with Genentech, Regeneron, and Aerpio. He receives research support from Genentech, Regeneron, Allergan, Aerpio, Genzyme, and Oxford BioMedica. These activities are being managed by the Conflict of Interest Committee of the Johns Hopkins University School of Medicine.",
year = "2014",
month = mar,
doi = "10.1038/eye.2013.245",
language = "English (US)",
volume = "28",
pages = "269--278",
journal = "Eye (Basingstoke)",
issn = "0950-222X",
publisher = "Springer Nature",
number = "3",
}