Clinical Characteristics and Long-term Outcomes in Diabetic Macular Edema Patients: With or without Additional Injection Following Ranibizumab Loading.

Q3 Medicine Korean Journal of Ophthalmology : KJO Pub Date : 2022-10-01 Epub Date: 2022-08-19 DOI:10.3341/kjo.2022.0086
Kyungwoo Yoon, Eung Suk Kim, Seung-Young Yu, Kiyoung Kim
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Abstract

Purpose: To investigate the baseline characteristics in patients with diabetic macular edema (DME) during 7 years according to the need for additional treatments after intravitreal ranibizumab (RBZ) loading injections.

Methods: The medical records of 32 patients treated with intravitreal RBZ loading for DME during 7 years were reviewed. After three-consecutive monthly RBZ injections, additional treatment was decided according to the patient's response to RBZ loading. Based on whether the patients received treatment with or without additional injections, including intravitreal antivascular endothelial factor or steroid injection, they were divided into the "no add (NA)" or "add" groups, respectively. The baseline best-corrected visual acuity (BCVA), macular volume (MV), central subfoveal thickness, and other clinical factors were analyzed, and their 7-year changes were compared between the two groups.

Results: The BCVA of the NA group was better than that of the add group at 2, 3, 5, and 7 years (year 2, 3, and 5; p < 0.01, respectively). Baseline MV was significantly smaller in the NA group than in the add group (10.72 ± 0.88 μm vs. 11.98 ± 1.64 μm, p = 0.008). The DME duration before treatment in the NA group was significantly shorter than in the add group (1.03 ± 0.98 years vs. 1.91 ± 1.33 years, p = 0.042). The proportion of patients with serous retinal detachment or cystic macular edema was significantly lower in the NA group than in the add group (35.3% vs. 73.3%, p = 0.042). The NA group had smaller MV until 2 years than the add group (year 1, p = 0.002; year 2, p = 0.006).

Conclusions: The DME patients without additional treatments during 7 years after the initial loading treatment had shorter duration of DME and diffuse retinal thickening morphologic type with lower MV at baseline, and better long-term visual prognosis.

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糖尿病性黄斑水肿患者的临床特征和长期结局:在雷尼单抗负荷后是否进行额外注射
目的:根据玻璃体内注射雷尼单抗(RBZ)后需要额外治疗的情况,研究糖尿病性黄斑水肿(DME)患者7年的基线特征。方法:回顾7年来32例玻璃体内RBZ负荷治疗二甲醚的病例。在连续三个月注射RBZ后,根据患者对RBZ负荷的反应决定额外的治疗。根据患者是否接受了额外的注射治疗,包括玻璃体内抗血管内皮因子或类固醇注射,分别分为“不添加(NA)”组和“添加”组。分析基线最佳矫正视力(BCVA)、黄斑体积(MV)、中央凹下厚度等临床因素,比较两组患者7年的变化。结果:NA组在2、3、5、7年时的BCVA均优于添加组(第2、3、5年;P < 0.01)。NA组基线MV显著小于添加组(10.72±0.88 μm vs. 11.98±1.64 μm, p = 0.008)。NA组治疗前DME持续时间显著短于添加组(1.03±0.98年∶1.91±1.33年,p = 0.042)。NA组出现浆液性视网膜脱离或囊性黄斑水肿的比例明显低于添加组(35.3% vs. 73.3%, p = 0.042)。NA组至2年时的MV小于添加组(第1年,p = 0.002;第二年,p = 0.006)。结论:DME patients在初始加载治疗后7年内未进行额外治疗,DME持续时间短,弥漫性视网膜增厚形态型,基线MV较低,长期视力预后较好。
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来源期刊
Korean Journal of Ophthalmology : KJO
Korean Journal of Ophthalmology : KJO Medicine-Ophthalmology
CiteScore
2.40
自引率
0.00%
发文量
84
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