Influence of the epiretinal membrane on ranibizumab therapy outcomes in patients with diabetic macular edema

Erçalık, Nimet Yeşim; İmamoğlu, Serhat; Kumral, Esra Türkseven; Yenerel, Nursal Melda; Bardak, Handan; Bardak, Yavuz

doi:10.5935/0004-2749.20160106

Cited by 16 publications

(21 citation statements)

References 17 publications

(22 reference statements)

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“…This means that patients with secondary ERM showed a smaller decrease of CMT after intravitreal injection than before ERM formation, and the effect of intravitreal injection was reduced after ERM formation. This supported the previous report that ERM may act as a physical barrier and decrease drug penetration 10 .…”

Section: Discussionsupporting

confidence: 93%

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Incidence and treatment outcomes of secondary epiretinal membrane following intravitreal injection for diabetic macular edema

Kang

Park

et al. 2020

Sci Rep

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Demographics of patient. One hundred thirty-four patients were initially enrolled, but 39 patients were excluded. Thus, a total of 95 patients (147 eyes) were enrolled in this study. The demographic and clinical characteristics of all patients are summarized in Table 1. Among the 95 patients (147 eyes), 46 were male, and 49 were female. The mean age of all patients was 59.7 ± 12.7 years, and the duration of diabetes mellitus was 15.3 ± 8.6 years. Thirty-five patients had hypertension,

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Section: Discussionsupporting

confidence: 93%

“…VEGF and its receptors are localized to both vascular and avascular ERM, and VEGF may contribute to the progression of DME 9 . Moreover, ERM may act as a physical barrier and decrease drug penetration after intravitreal injections of anti-VEGF or steroids in DME treatment 10 .…”

Section: Incidence and Treatment Outcomes Of Secondary Epiretinal Memmentioning

confidence: 99%

Incidence and treatment outcomes of secondary epiretinal membrane following intravitreal injection for diabetic macular edema

Kang

Park

et al. 2020

Sci Rep

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“…The simultaneous presence of ERM and diabetic macular edema may affect the therapeutic role of anti-VEGF agents on DME. To date, only very few studies have focused on effect of epiretinal membrane on outcomes of intravitreal anti-VEGFs for treating DME and results of these studies are not consistent [ 10 , 11 ]. Also, none of them has been specifically studied the effect of Bevacizumab.…”

Section: Introductionmentioning

confidence: 99%

Short term effect of intravitreal bevacizumab for diabetic macular edema associated with epiretinal membrane

Maryam¹,

Tafgeh²,

Mahmoud³

et al. 2018

rjo

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Purpose: To evaluate the effect of intravitreal bevacizumab (IVB) injection on central macular thickness (CMT) in patients with diabetic macular edema (DME) associated with epiretinal membrane (ERM) and compare the results to those with DME without ERM.Methods: 54 eyes of 54 patients with DME were included in this prospective comparative case series. Twenty-eight patients had ERM. All patients received 2.5 mg/ 0.1 ml IVB. The primary outcome measure was the change in central macular thickness (CMT) and the secondary outcome measure was the change in best corrected visual acuity (BCVA), one month after the IVB injection.Results: All the patients completed 1-month follow-up. One month after the IVB injection, there was no statistically significant reduction in terms of CMT for the ERM group (22.64 ± 70.1 μm; P = 0.099), unlike eyes with DME alone (60.34 ± 88.5 µm; P = 0.002). Patients with ERM had a -0.09 ± 0.14 log MAR improvement in their BCVA (P =0.001) vs. 0.03 ± Log MAR change in the patients who did not have ERM (P = 0.37).Conclusion: In this study, intravitreal bevacizumab resulted in improvement in BCVA in patients who had DME associated with ERM. However, in patients who only had DME, despite a reduction in CMT, no improvement in BCVA occurred. Future randomized clinical trials are warranted to precisely assess the effect of bevacizumab on the ERM.

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“…유리 체와 망막조직에서 발현되어 당뇨망막병증의 병태 생리에 중요 한 역할을 하는 염증성 사이토카인 인터루킨-6는 [25] 망막 혈관 신생의 가장 중요한 일차 매개체인 혈관내피세포성장인자의 발 현을 유도하는 것으로 보고되고 있으며 [26,27], 혈관내피세포성 장인자와 그 수용체와 함께 당뇨망막병증 환자의 혈관성 망막 앞막과 무혈관성 망막앞막에 위치하여 염증을 증가시키고 지속 적인 당뇨황반부종을 유발하는 것으로 알려져 있다 [22,28]. 망 막앞막을 동반한 당뇨황반부종 환자는 더 많은 횟수의 항혈관 내피세포성장인자 주사를 필요로 하지만, 망막앞막이 물리적 장벽으로 작용하여 약물의 투과를 감소시키는 것으로 보고되 고 있다 [29]. 당뇨황반부종에서 유리체황반경계면 이상이 동반 되는 경우 항혈관내피세포성장인자에 대한 치료 효과는 감소 될 수 밖에 없다 [29][30][31] (Fig.…”

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“…망 막앞막을 동반한 당뇨황반부종 환자는 더 많은 횟수의 항혈관 내피세포성장인자 주사를 필요로 하지만, 망막앞막이 물리적 장벽으로 작용하여 약물의 투과를 감소시키는 것으로 보고되 고 있다 [29]. 당뇨황반부종에서 유리체황반경계면 이상이 동반 되는 경우 항혈관내피세포성장인자에 대한 치료 효과는 감소 될 수 밖에 없다 [29][30][31] (Fig. 1).…”

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Short-term Effect of Intravitreal Dexamethasone Implant on Diabetic Macular Edema with Epiretinal Membrane

Noh

Ahn

Lee

et al. 2017

J Retin

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Purpose: To assess the short term effect of an intravitreal dexamethasone implant on diabetic macular edema (DME) with epiretinal membrane (ERM). Methods: We conducted a retrospective study including 39 eyes of 39 patients with DME who underwent intravitreal dexamethasone implant injection and were able to be observed for more than 6 months. Patients were divided into two groups according to presence or absence of ERM from March 2015 to June 2016. Results: Thirteen DME eyes with ERM and 26 DME eyes without ERM were enrolled. The classification of ERM was grade 0 in 5 (38.5%) eyes, grade 1 in 7 eyes (53.8%) and grade 2 in 1 eye (7.7%). There was no difference in best corrected visual acuity (BCVA) and central macular thickness (CMT) between the DME with ERM group and the DME without ERM group at baseline. After the injection, there was no difference in mean BCVA and mean CMT between the two groups at 1, 3, and 6 months. DME without ERM group showed a significant decrease in CMT compared to baseline at 1, 3, and 6 months (p < 0.001, p = 0.003, p = 0.001, respectively). The DME with ERM group showed a significant decrease in CMT compared to baseline at 1 and 3 months, but no difference at 6 months (p = 0.048, p = 0.024, p = 0.275, respectively). Conclusions: Intravitreal dexamethasone implantation may be a useful treatment modality for patients with DME with ERM, but the duration of the anatomical improvement may be shorter than that for patients with DME without ERM.

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Influence of the epiretinal membrane on ranibizumab therapy outcomes in patients with diabetic macular edema

Cited by 16 publications

References 17 publications

Incidence and treatment outcomes of secondary epiretinal membrane following intravitreal injection for diabetic macular edema

Incidence and treatment outcomes of secondary epiretinal membrane following intravitreal injection for diabetic macular edema

Short term effect of intravitreal bevacizumab for diabetic macular edema associated with epiretinal membrane

Short-term Effect of Intravitreal Dexamethasone Implant on Diabetic Macular Edema with Epiretinal Membrane

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