ĐÁNH GIÁ HIỆU QUẢ CỦA RANIBIZUMAB TIÊM NỘI NHÃN TRONG ĐIỀU TRỊ PHÙ HOÀNG ĐIỂM ĐÁI THÁO ĐƯỜNG

Abstract

Objectives: To evaluate the effect of intravitreal ranibizumab injection for clinically significant diabetic macular edema (DME). Methods: This is quasi experimental study. These eyes with diabetic macular edema had baseline best-corrected visual acuity (BCVA) 20/40 (70 ETDRS letters) to 20/320 (10 ETDRS letters) and central retinal thickness (CRT) ≥ 250 µm on optical coherence tomography. Patients were treated with 3 consecutive monthly intravitreal 0.5mg ranibizumab injections then injections until BCVA 20/20 or stable (regardless of OCT findings). Followed up 24 weeks. Results: Enrolled 21 eyes of 15 patients (8 males and 7 females) with diabetic macular edema with 4.9 ± 1.2 injections at 24 weeks. Mean best-corrected visual acuity ETDRS letter score at baseline was 54.9 ± 3.6 letters and increased significantly (p < 0.0001) by 14.9 ± 10.1 letters to 69.7 ± 3.3 letters at 24 weeks. Baseline central foveal thickness was 442.9 ± 28.9 µm and decreased significantly (p < 0.0001) by 189,0 ± 32,3 µm to 253.9 ± 10,2 µm at 24 weeks. Significant improvements in macular edema were noted on OCT, and retinopathy was less likely to worsen and more likely to improve in ranibizumab-treated patients. There are no complications such as retinal detachment, endophthalmitis, vitreous hemorrhage,... BCVA background <60 ETDRS letters ~ <3/10 risk that not successfully reaching 8.8 times compared to the group with BCVA baseline ≥ 60 ETDRS letters ~ ≥ 3/10; tested Fisher's Exact; RR = 8.8; 95% CI (1.324 to 58.500); p = 0.002. Conclusions: Ranibizumab therapy in the treatment of diabetic macular edema improve significantly retinal function and structure.