Intravitreal ranibizumab yields long-term improvements in diabetic retinopathy severity

Patients who received intravitreal ranibizumab treatment alone showed better improvement in diabetic retinopathy severity than patients receiving sham and intravitreal ranibizumab treatment, according to a study.

The study analyzed the RISE and RIDE trials, which included 759 patients with diabetic macular edema (DME) randomized to receive 0.3 mg or 0.5 mg ranibizumab (Lucentis, Genentech), or sham injections.

Patients had baseline best-corrected visual acuity of 20/40 to 20/320 Snellen equivalent and central foveal thickness of less than or equal to 275 µm, the study said.

A significant number of eyes treated with ranibizumab showed less than two or three-step diabetic retinopathy (DR) improvement at 3 months. At 3 months, there was less than a 3-step improvement in 3.3% of eyes treated with 0.5 mg sham injections, 15% of eyes treated with 0.3 mg ranibizumab and 13.2% of eyes treated with 0.5 mg ranibizumab, according to study results.

Furthermore, more sham-treated eyes developed proliferative DR than ranibizumab-treated eyes. Thirty-nine percent of sham-treated eyes developed proliferative DR compared to 18.3% of 0.3 mg ranibizumab-treated eyes and 17.1% of 0.5 mg ranibizumab-treated eyes.

Patients treated with sham who crossed over to 0.5 mg ranibizumab treatment after 2 years showed improvement in retinopathy severity but treatment was not as effective as when ranibizumab was given for 3 years straight.

“The data [also] highlight the importance of early intervention in the DME patient population, in order to take full advantage of the ancillary effect on DR severity level,” study authors said.

Disclosure: See the study for full list of all authors’ relevant financial disclosures.