Andreas Ebneter1,2, Dominik Waldmeier3, Denise C Zysset-Burri3, Sebastian Wolf3, Martin Sebastian Zinkernagel3. 1. Department of Opthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. andreas.ebneter@insel.ch. 2. Universitätsklinik für Augenheilkunde, Inselspital, 3010, Bern, Switzerland. andreas.ebneter@insel.ch. 3. Department of Opthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Abstract
PURPOSE: To compare outcomes between an as-needed and a treat-and-extend regimen in managing diabetic macular edema with intravitreal ranibizumab. METHODS: This was a retrospective, single-centre, comparative case series on 46 treatment naive patients with diabetic macular edema. Twenty-two patients were treated following an optical coherence tomography guided treat-and-extend protocol (OCTER), and 24 patients were treated according to a visual acuity guided pro re nata regimen (VAPRN) at a tertiarry referral centre. The main outcome measures were best-corrected visual acuity, central retinal thickness, and the number of ranibizumab injections, as well as visits after 12 months of treatment. RESULTS: After 12 months, the mean gain in best-corrected visual acuity (± standard deviation) was 8.3 ± 6.7 versus 9.3 ± 8.9 letters in the VAPRN and OCTER group, respectively (p = 0.3). The mean decrease in central retinal thickness was 68.1 ± 88.0 μm in the VAPRN group and 117.6 ± 114.4 μm in the OCTER group (p = 0.2). The mean number of ranibizumab injections was significantly different between the VAPRN (5.9 ± 1.8) and the OCTER protocol (8.9 ± 2.0) (p < 0.001). CONCLUSION: The visual acuity driven retreatment regimen resulted in a similar visual acuity outcome like optical coherence tomography guided retreatment for diabetic macular edema. Although the number of visits was similar in both groups, patients in the VAPRN group received significantly fewer intravitreal injections than patients in the OCTER group.
PURPOSE: To compare outcomes between an as-needed and a treat-and-extend regimen in managing diabetic macular edema with intravitreal ranibizumab. METHODS: This was a retrospective, single-centre, comparative case series on 46 treatment naive patients with diabetic macular edema. Twenty-two patients were treated following an optical coherence tomography guided treat-and-extend protocol (OCTER), and 24 patients were treated according to a visual acuity guided pro re nata regimen (VAPRN) at a tertiarry referral centre. The main outcome measures were best-corrected visual acuity, central retinal thickness, and the number of ranibizumab injections, as well as visits after 12 months of treatment. RESULTS: After 12 months, the mean gain in best-corrected visual acuity (± standard deviation) was 8.3 ± 6.7 versus 9.3 ± 8.9 letters in the VAPRN and OCTER group, respectively (p = 0.3). The mean decrease in central retinal thickness was 68.1 ± 88.0 μm in the VAPRN group and 117.6 ± 114.4 μm in the OCTER group (p = 0.2). The mean number of ranibizumab injections was significantly different between the VAPRN (5.9 ± 1.8) and the OCTER protocol (8.9 ± 2.0) (p < 0.001). CONCLUSION: The visual acuity driven retreatment regimen resulted in a similar visual acuity outcome like optical coherence tomography guided retreatment for diabetic macular edema. Although the number of visits was similar in both groups, patients in the VAPRN group received significantly fewer intravitreal injections than patients in the OCTER group.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: K Bailey Freund; Jean-François Korobelnik; Robert Devenyi; Carsten Framme; John Galic; Edward Herbert; Hans Hoerauf; Paolo Lanzetta; Stephan Michels; Paul Mitchell; Jordi Monés; Carl Regillo; Ramin Tadayoni; James Talks; Sebastian Wolf Journal: Retina Date: 2015-08 Impact factor: 4.256
Authors: Quan Dong Nguyen; David M Brown; Dennis M Marcus; David S Boyer; Sunil Patel; Leonard Feiner; Andrea Gibson; Judy Sy; Amy Chen Rundle; J Jill Hopkins; Roman G Rubio; Jason S Ehrlich Journal: Ophthalmology Date: 2012-02-11 Impact factor: 12.079
Authors: Ursula Schmidt-Erfurth; Gabriele E Lang; Frank G Holz; Reinier O Schlingemann; Paolo Lanzetta; Pascale Massin; Ortrud Gerstner; Abdelkader Si Bouazza; Haige Shen; Aaron Osborne; Paul Mitchell Journal: Ophthalmology Date: 2014-02-01 Impact factor: 12.079
Authors: Christian Prünte; Franck Fajnkuchen; Sajjad Mahmood; Federico Ricci; Katja Hatz; Jan Studnička; Vladimir Bezlyak; Soumil Parikh; William John Stubbings; Andreas Wenzel; João Figueira Journal: Br J Ophthalmol Date: 2015-10-09 Impact factor: 4.638
Authors: Petra Arendt; Siqing Yu; Marion R Munk; Andreas Ebneter; Sebastian Wolf; Martin S Zinkernagel Journal: Retina Date: 2019-01 Impact factor: 4.256
Authors: Anika Tanwani; Nida Safdar; Amir Ali; Cina Karimaghaei; Mary Schmitz-Brown; Ahmad Rehmani; Praveena K Gupta Journal: Life (Basel) Date: 2021-12-31