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Moradi A, Sepah YJ, Ibrahim MA, Sophie R, Moazez C, Bittencourt MG, Annam RE, Hanout M, Liu H, Ferraz D, Do DV, Nguyen QD. Association of retinal vessel calibre and visual outcome in eyes with diabetic macular oedema treated with ranibizumab. Eye (Lond) 2014; 28:1315-20. [PMID: 25145456 DOI: 10.1038/eye.2014.186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/26/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The study aims to identify the association between the baseline retinal vascular calibre and visual outcome of patients with diabetic macular oedema (DMO) treated with intravitreal ranibizumab. METHODS The 1-M field (as defined in the ETDRS study) of the digital colour fundus photographs of DMO patients who had been treated primarily with ranibizumab in a clinical trial was assessed. Of the 84 patients, 25 had gradable retinal photographs that could be subjected to analyses by the Interactive Vessel Analysis (IVAN) software at baseline. The average retinal vascular calibre of the six largest venules (CRVE) and the six largest arterioles (CRAE) in the peripapillary area (0.5 and 1 disc diameter from the optic disc margin) was measured. The relationship between CRVE and CRAE at baseline and the change in visual acuity at month 12 was assessed using the Mann-Whitney U test. RESULTS Ten eyes from 10 patients who had shown an improvement of ≥2 lines of best corrected visual acuity (BCVA) at month 12 had a wider baseline CRVE (248.3±24.5 μm) compared with the 15 eyes from 15 patients who did not show the improvement of ≥2 lines (226.6±44.8 μm, P<0.05). The baseline CRAE did not differ significantly in these patients (156.1±22.7 vs 142±17.5 μm, P=0.17). CONCLUSIONS A wider baseline retinal venular calibre may be a predictor of better visual outcome in DMO eyes treated with ranibizumab. Further prospective studies with a larger sample size and a broader range of disease severity and visual acuity are needed to confirm this finding.
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Affiliation(s)
- A Moradi
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Y J Sepah
- 1] Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA [2] Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
| | - M A Ibrahim
- 1] Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA [2] Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
| | - R Sophie
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C Moazez
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M G Bittencourt
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R E Annam
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M Hanout
- 1] Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA [2] Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
| | - H Liu
- Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D Ferraz
- 1] Retinal Imaging Research and Reading Centre, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA [2] Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
| | - D V Do
- Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
| | - Q D Nguyen
- Ocular Imaging Research and Reading Centre, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, NE, USA
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Channa R, Sophie R, Khwaja AA, Do DV, Hafiz G, Nguyen QD, Campochiaro PA. Factors affecting visual outcomes in patients with diabetic macular edema treated with ranibizumab. Eye (Lond) 2013; 28:269-78. [PMID: 24263379 DOI: 10.1038/eye.2013.245] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/08/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To identify factors associated with visual outcomes in patients with diabetic macular edema (DME) treated with ranibizumab (RBZ) in the Ranibizumab for Edema of the mAcula in Diabetes-Protocol 2 (READ-2) Study. PATIENTS AND METHODS Optical coherence tomography scans, fundus photographs, and fluorescein angiograms (FAs) were graded and along with baseline characteristics were correlated with month (M) 24 visual outcome of best-corrected visual acuity (BCVA) ≤20/100 (poor outcome) vs >20/100 (better outcome). RESULTS Of 101 patients with a M20 visit or beyond, 27 (27%) had BCVA ≤20/100. Comparison of patients with or without poor outcome showed mean baseline BCVA of 16.8 letters (20/125) in the former compared with 30.4 letters (20/63; P<0.001). Mean change in BCVA between baseline and M24 was -2.6 letters in the poor outcome group compared with +9.8 letters (P<0.001). Foveal thickness (FTH) at M24 was 374.1 μm in the poor outcome group compared with 268.8 μm (P<0.01), a difference driven by 14 patients with mean FTH of 450.3 μm. Foveal atrophy occurred in 65% (11/17) in the poor outcome group compared with 17%(12/71, P=0.001). Persistent edema was noted in 52% (14/27) of patients with poor outcome. Laser scars near foveal center were significantly more common in patients with poor outcome who did not have edema vs those who did (78% (7/9) vs 23% (3/13) P=0.03). CONCLUSION Poor baseline BCVA (≤20/125) in DME patients predicts poor visual outcome (≤20/100) after 2 years of treatment with RBZ and/or focal/grid laser, often due to foveal atrophy and/or persistent edema.
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Affiliation(s)
- R Channa
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R Sophie
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A A Khwaja
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D V Do
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - G Hafiz
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Q D Nguyen
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P A Campochiaro
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Bueno H, Armstrong PW, Buxton MJ, Danchin N, Lubsen J, Roland E, Verheugt FW, Zalewski A, Jackson N, Komajda M, Steg PG, Christoph Bode PWA, Francois Chazelle HBMJB, Nancy Cook-Bruns ND, Pantaleo Giannuzzi NJMK, Pasquale LS, Katrin L, Susan Longman JL, Punet M, Alain Rimailho ER, Sophie R, Luc S, Florence Scheck PGS, Peter S, Frans Van de Werf FWV, Lars Wallentin AZ, Faiez Z. The future of clinical trials in secondary prevention after acute coronary syndromes. Eur Heart J 2010; 32:1583-9. [DOI: 10.1093/eurheartj/ehq388] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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