Repeated Ranibizumab Injections Does Not Impair Macular Perfusion

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There were no changes in foveal avascular zone regularity in any treatment group.
There were no changes in foveal avascular zone regularity in any treatment group.

HealthDay News — For patients with diabetic macular edema, repeated ranibizumab treatment does not appear to be associated with impaired macular perfusion, according to a study published online in JAMA Ophthalmology.

Sonja G. Karst, MD, from the Medical University Vienna, and colleagues analyzed prospectively collected data from 208 patients with diabetic macular edema who completed the 12-month RESTORE core study and the 24-month open label RESTORE extension study.

The authors sought to examine the correlation of repeated ranibizumab injection on macular perfusion.

The researchers found that at baseline, the mean foveal avascular zone size was 0.261 mm² in ranibizumab monotherapy, 0.231 mm² in ranibizumab and macular laser combination therapy, and 0.201 mm² in laser monotherapy. No significant increase in foveal avascular zone size was experienced by any treatment arm at any time in the study period.

At month 36, the mean increases for ranibizumab monotherapy and combination therapy were 0.073 and 0.117 mm², respectively; no changes were statistically significant. There were no changes in foveal avascular zone regularity in any treatment group, and in the 3 treatment groups, there were no differences in capillary loss around the fovea. Neither element correlated with visual acuity or central retinal thickness.

"Because our data do not suggest a harmful effect of anti-vascular endothelial growth factor therapy on capillary integrity, patients with severe microangiopathy and advanced capillary dropout should not be denied these treatments," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; image grading, data collection and analysis, and manuscript preparation were sponsored by Novartis.

Reference

Karst SG, Deak GG, Gerendas BS, et al. Association of changes in macular perfusion with ranibizumab treatment for diabetic macular edema: a subanalysis of the RESTORE (extension) study [published online March 1, 2018]. JAMA Ophthalmol. doi: 10.1001/jamaophthalmol.2017.6135

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