Glucose regulation influences treatment outcome in ranibizumab treatment for diabetic macular edema

Influence of Glycosylated Hemoglobin on the Efficacy of Ranibizumab for Diabetic Macular Edema

“…We found no significant differences in the 36-month vision, change in vision, or 36-month CFT between patients with baseline HbA1c 7% and >7%, or between patients stratified by quartiles of baseline HbA1c. Our results are similar to those of Ozturk et al, 18 who found no relationship between the baseline HbA1c and improvement in VA after a single intravitreal injection of ranibizumab. Although there was a statistically significant difference in the change in CFT from baseline at 36 months between the 2 groups, this could be accounted for by the fact that the baseline CFT was significantly thicker in the group with baseline HbA1c 7%.…”

The Impact of Systemic Factors on Clinical Response to Ranibizumab for Diabetic Macular Edema

“…10 In a retrospective study of 124 patients, Matsuda et al 12 recently showed that, in patients with HbA1c values of more than 7%, less robust anti-VEGFemediated improvements in BCVA and central subfield macular thickness were achieved than in patients with HbA1c levels of 7% or less. Similar findings from 65 patients were reported by Ozturk et al, 13 wherein reduction in DME with anti-VEGF therapy was correlated negatively with HbA1c level. However, these studies were retrospective analyses, with variable follow-up and nonstandardized treatment regimens.…”

Intravitreal bevacizumab injections for diabetic macular edema – predictors of response: a retrospective study

“…In the BOLT study, all patients had prior treatment with laser, but the number of laser treatments was not associated with the change in CMT at 24 months 9. Another study found no difference in CMT change after a single injection of IVR in patients who had previous treatment for DME versus those that did not; however, the former group did have a greater gain in VA 8. The patients in our cohort who had previous macular laser could represent a more treatment-refractory group.…”

“…One study looked at the response after a one-dose injection of ranibizumab and found that serum HbA1c levels were negatively correlated with the change in CMT 8. Another study examined the effects of IVB on CMT at 1 year and found that patients with HbA1c levels ≤7.0% at baseline had greater reductions in CMT (statistically significant) than patients with a HbA1c level ≥7.0% 25.…”

“…Outcomes seem to be variable among patients, so recent reports have focused on identifying predictors of response. These have looked at systemic8,9 or ocular factors,10 but not in conjunction with each other, which could be important since these factors may be interrelated.…”