Lai Chun-Ting, Hsieh Yi-Ting, Lin Chun-Ju, Wang Jia-Kang, Lin Chih-Ying, Hsia Ning-Yi, Bair Henry, Chen Huan-Sheng, Chiu Chiung-Yi, Weng Shao-Wei
Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Front Med (Lausanne). 2021 May 3;8:668107. doi: 10.3389/fmed.2021.668107. eCollection 2021.
We report the tri-center 1-year outcomes of a treat-and-extend (T&E) regimen in four-week intervals with ranibizumab for diabetic macular edema (DME). In this retrospective study, all eyes received 3 monthly loading injections of 0.5 mg ranibizumab, followed by a T&E regimen for DME. Regression models were used to evaluate the associating factors for visual and anatomical outcomes. Ninety one eyes from 64 patients were enrolled. Mean LogMAR best-corrected visual acuity (BCVA) improved from 0.58 at baseline to 0.36 at month 12 and mean central retinal thickness (CRT) decreased from 411 μm at baseline to 290 μm at month 12. Younger age and eyes having thinner baseline CRT, with ellipsoid zone disruption (EZD), and without epiretinal membrane (ERM) were associated with better final CRT. Moreover, eyes with thicker baseline CRT tend to receive more injections. Among the parameters, only having ERM or EZD was associated with significant BCVA recovery. A T&E regimen with ranibizumab by 4-week intervals is effective in improving BCVA and reducing CRT with efficacy notable starting from the third month. Clinical parameters including age, initial CRT, and presence of ERM or EZD significantly influenced therapeutic outcomes. Moreover, the presence of ERM should not preclude DME patients from receiving anti-VEGF therapy. Future studies with larger cohorts are warranted.
我们报告了一项为期1年的三中心研究结果，该研究采用雷珠单抗以四周间隔进行治疗并延长（T&E）方案治疗糖尿病性黄斑水肿（DME）。在这项回顾性研究中，所有患眼均接受3次每月一次的0.5mg雷珠单抗负荷注射，随后采用T&E方案治疗DME。使用回归模型评估视觉和解剖学结果的相关因素。纳入了64例患者的91只眼。平均LogMAR最佳矫正视力（BCVA）从基线时的0.58提高到第12个月时的0.36，平均中心视网膜厚度（CRT）从基线时的411μm降至第12个月时的290μm。年龄较小、基线CRT较薄、存在椭圆体带破坏（EZD）且无视网膜前膜（ERM）的患眼，最终CRT改善情况较好。此外，基线CRT较厚的患眼往往需要接受更多次注射。在这些参数中，仅存在ERM或EZD与BCVA显著恢复相关。雷珠单抗每四周一次的T&E方案可有效改善BCVA并降低CRT，从第三个月起疗效显著。包括年龄、初始CRT以及ERM或EZD的存在等临床参数显著影响治疗效果。此外，存在ERM不应妨碍DME患者接受抗VEGF治疗。有必要开展更大样本队列的未来研究。
