Open AccessRelation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema
Author(s) -
Yutaka Mori,
Tomoaki Murakami,
Kiyoshi Suzuma,
Kenji Ishihara,
Shin Yoshitake,
Masahiro Fujimoto,
Yoko Dodo,
Tatsuya Yoshitake,
Yuko Miwa,
Akitaka Tsujikawa
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0175809
Subject(s) - medicine , pro re nata , ranibizumab , external limiting membrane , ophthalmology , diabetic macular edema , visual acuity , diabetic retinopathy , retinal , optical coherence tomography , macular edema , univariate analysis , multivariate analysis , diabetes mellitus , bevacizumab , surgery , retinal pigment epithelium , chemotherapy , endocrinology
Purpose To investigate whether baseline optical coherence tomography (OCT) parameters can predict the treatment frequency of intravitreal ranibizumab (IVR) injections during the first year in patients with diabetic macular edema (DME) treated with pro re nata (PRN) IVR injections. Methods We retrospectively reviewed 68 eyes of 63 patients with center-involved DME who received IVR injections for 12 months or longer according to three monthly IVR injections followed by the PRN dosing. We measured the mean retinal thicknesses in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid and evaluated the qualitative and quantitative parameters on OCT sectional images. We investigated the relationship between these OCT parameters at baseline and the number of IVR injections during the 12-month follow-up. Results Three loading doses were administered to 10 eyes; four to seven annualized IVR injections were administered to 34 eyes. The number of eyes that received IVR injections decreased gradually until month 6 and was almost constant from months 7 to 11. No relationships were seen between the treatment frequency and baseline systemic factors and the ophthalmic examination findings. Univariate analyses showed that the number of IVR injections during the first year was associated with the mean retinal thickness in the individual subfields and the transverse length of the disrupted external limiting membrane (ELM) and ellipsoid zone of the photoreceptors. Multivariate analysis showed a significant association with the thickness in the inferior subfield alone. The treatment frequency during the 12-month follow-up was not correlated with improved visual acuity but was associated with the decrease in the central subfield thickness and disrupted ELM. Conclusion The retinal thickness in the inferior subfield predicts the treatment frequency during the first year in eyes with DME treated with PRN IVR injections.