Abstract
Purpose
Diabetic macular oedema (DMO) is a leading cause for visual impairment in the working age population in the UK. Ranibizumab has been shown to be effective in treatment of DMO in studies based on mainly Caucasian populations. This study reports the 12-month outcome in a cohort of South Asian subjects with DMO treated with ranibizumab.
Methods
DMO in 51 eyes of 41 South Asian patients was treated with ranibizumab 0.5 mg according to the modified DRCRnet protocol I. Visual acuity (VA) and central macular thickness (CMT) were recorded at baseline, 3, 6, and 12 months. Results were compared for eyes with different baseline visual acuities and different baseline macular thicknesses.
Results
Over the 12-month period, the mean ETDRS VA increased from 55.3±13.4 letters to 63.8±15.2 letters for all eyes. At 12 months, 70.6% eyes gained 5 or more letters acuity and 17.6% eyes gained 15 letters or more. During the same period, the mean CMT decreased from 532±129 to 318±136 μm. Eyes that had received previous laser treatments had a mean letter gain of 9.2 letters, compared with 8.5 for all eyes at 12 months.
Conclusions
Ranibizumab 0.5 mg is safe and effective at reversing vision loss due to DMO in patients of South Asian origin at 12 months. Ranibizumab treatment appears to be effective in patients with longstanding DMO who received prior laser treatments. Further studies are needed to define the long-term outcome in patients of different ethnicity and DMO.
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References
Sivaprasad S, Gupta B, Gulliford MC, Dodhia H, Mann S, Nagi D et al. Ethnic variations in the prevalence of diabetic retinopathy in people with diabetes attending screening in the United Kingdom (DRIVE UK). PLoS One 2012; 7: e32182.
Massin P, Bandello F, Garweg JG, Hansen L, Larsen M, Mitchell P et al. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study). Diabetes Care 2010; 33: 2399–2405.
Nguyen QD, Shah SM, Khwaja AA, Channa R, Sepah YJ, Sophie R et al. Two-year outcomes of the ranibizumab for edema of the macula in Diabetes (READ—2) Study. Ophthalmology 2010; 117: 2146–2151.
Nguyen QD, Brown DM, Marcus DM, Boyer DS, Patel S, Feiner L et al. Ranibizumab for diabetic macular edema. Results from 2 Phase III Randomized trials: RISE and RIDE. Ophthalmology 2012; 119: 789–801.
Brown DM, Nguyen QD, Marcus DM, Boyer DS, Patel S, Feiner L et al. Long-term outcomes of ranibizumab therapy for diabetic macular edema: The 36-month results from two phase III Trials. RISE and RIDE. Ophthalmology 2013; 120: 2013–2022.
Wells JA, Glassman AR, Ayala AR, Jampol LM, Aiello LP, Antoszyk AN et al. Diabetic Retinopathy Clinical Research Network. Aflibercept, Bevacizumab, or Ranibizumab for Diabetic Macular Edema. N Engl J Med 2015; 372 (13): 1193–1203.
Sivaprasad S, Gupta B, Crosby-Nwaobi R, Evans J . Prevalence of diabetic retinopathy in various ethnic groups: A world-wide perspective. Surv Ophthalmol 2012; 57: 347–370.
Gupta B . http://dspace.lib.cranfield.ac.uk/handle/1826/7165 (accessed 13 May 2014).
Diabetes UK, Diabetes in the UK 2012. Key statistics on diabetes. Available from http://www.diabetes.org.uk/Documents/Reports/Diabetes-in-the-UK-2012.pdf (accessed 14 January 2014).
Health Survey for England 2004. Health of ethnic minorities. Available from www.ic.nhs.uk/pubs/hse04ethnic (accessed 14 Jan 2014).
Dreyer G, Hull S, Aitken Z, Chesser A, Yaqoob MM . The effect of ethnicity on the prevalence of diabetes and associated chronic kidney disease. QJM 2009; 102: 261–269.
Diabetic Retinopathy Clinical Research Network, Aiello LP, Beck RW, Bressler NM, Browning DJ, Chalam KV, Davis M et al. Rationale for the diabetic retinopathy clinical research network treatment protocol for centre-involving diabetic macular edema. Ophthalmology 2011; 118: e5–e14.
Mitchell P, Bandello F, Schmidt-Erfurth U, Lang GE, Massin P, Schlingemann RO et al. The RESTORE Study. Ranibizumamb monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology 2011; 118: 615–625.
Bradford City CCG. Available from http://www.bradfordcityccg.nhs.uk/wp-content/uploads/2013/10/Bradford-Citys-objectives-for-website.pdf (accessed 13 May 2015).
Diabetes Community Health Profile for Bradford and Airedale PCT. http://www.yhpho.org.uk/diabetescommunityhealthprofiles/default.aspx.
Elman MJ, Qin H, Aiello LP, Beck RW, Bressler NM, Ferris FL III et al. Intravitreal ranibizumab for diabetic macular edema with prompt vs deferred laser treatment: 3-year randomized trial results. Ophthalmology 2012; 119: 2312–2318.
Leung CK, Cheung CY, Weinreb RN, Lee G, Lin D, Pang CP et al. Comparison of macular thickness measurements between time domain and spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci 2008; 49: 4893–4897.
Alasil T, Pearse KA, Updyke JF, Dustin L, Ouyang Y, Walsh AC et al. Relationship between optical coherence tomography retinal parameters and visual acuity in diabetic macular edema. Ophthalmology 2010; 117: 2379–2386.
Pelosini L, Hull CC, Boyce JF, McHugh D, Stanford MR, Marshall J . Optical coherence tomography may be used to predict visual acuity in patients with macular edema. Invest Ophthalmol Vis Sci 2011; 52: 2741–2748.
Acknowledgements
We would like to thank consultant ophthalmologists Tomas Cudrnak, Helen Devonport, and Roopa Setty, who worked at the Macula Clinic during the course of the study.
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FG has received educational grants from Novartis, Bayer, and carried out consultancy for Novartis, Bayer, Allergan, and Alimera. FG and CH are involved in research studies by Novartis, Bayer. FG has received educational grants from Novartis. The department receives research funding from Novartis.
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Ghanchi, F., Hazel, C. South Asian diabetic macular oedema treated with ranibizumab (ADMOR)—real-life experience. Eye 30, 133–138 (2016). https://doi.org/10.1038/eye.2015.209
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DOI: https://doi.org/10.1038/eye.2015.209
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