Korean J Ophthalmol.  2018 Aug;32(4):296-302. 10.3341/kjo.2017.0117.

Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema with Serous Retinal Detachment

• Kaya M
• Karahan E
• Ozturk T
• Kocak N
• Kaynak S

• KMID: 2418150
• DOI: http://doi.org/10.3341/kjo.2017.0117

Abstract

PURPOSE
To evaluate the effectiveness of intravitreal injection of ranibizumab (IVR) in treating diabetic macular edema (DME) with serous retinal detachment (SRD) based on spectral domain optical coherence tomography (SD-OCT) patterns.
METHODS
One hundred thirty-four eyes of 134 patients with DME who underwent SD-OCT evaluation were included in this study. We retrospectively analyzed the medical records of patients who received IVR for the treatment of DME. Their eyes were classified into three groups according to the following SD-OCT features: SRD, diffuse retinal thickness and cystoid macular edema. The three groups were compared regarding changes in best-corrected visual acuity and central foveal thickness (CFT) after IVR.
RESULTS
The mean age was 61.4 ± 9.2 years (range, 44 to 81 years). The average length of the follow-up period was 9.4 ± 3.4 months (range, 6 to 24 months). The mean CFT value was significantly reduced in all groups (p < 0.001) after treatment. Increases in best-corrected visual acuity were statistically significant for the diffuse retinal thickness and cystoid macular edema groups (p < 0.001 and p < 0.001, respectively). However, there was no significant improvement after IVR injection in the SRD group (p = 0.252). In the SRD group, patients with ellipsoid zone disruption and external limiting membrane disruption demonstrated poorer visual gains at the last follow-up visit (p < 0.005 and p = 0.002, respectively).
CONCLUSIONS
A significant reduction in CFT with required IVR injections in DME with SRD was achieved but was accompanied by a worse functional outcome in the SRD group. The presence of subretinal fluid on SD-OCT in study eyes may be a poor prognostic factor for visual acuity.

Keyword

Diabetic macular edema; Ranibizumab; Serous retinal detachment; Spectral domain optical coherence tomography; Visual acuity

MeSH Terms

Follow-Up Studies
Humans
Intravitreal Injections
Macular Edema*
Medical Records
Membranes
Ranibizumab*
Retinal Detachment*
Retinaldehyde*
Retrospective Studies
Subretinal Fluid
Tomography, Optical Coherence
Visual Acuity
Ranibizumab
Retinaldehyde

Figure

• 

  Fig. 1 Diabetic macular edema (DME) classification based on spectral domain optical coherence tomography. (A) Patients with predominant serous retinal detachment DME had an associated subretinal collection of fluid under the fovea. (B) Diffuse DME patients demonstrated widespread retinal thickening with a sponge-like appearance of the macula. (C) Patients with focal cystoid DME had a mound-like appearance of the fovea due to focal collection of fluid at the fovea.

• 

  Fig. 2 Central foveal thickness (CFT) changes of the groups. SRD = serous retinal detachment; DRT = diffuse retinal thickness; CME = cystoid macular edema.

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  Fig. 3 Results of best-corrected visual acuity (BCVA) in eyes with decreased diabetic macular edema. SRD = serous retinal detachment; DRT = diffuse retinal thickness; CME = cystoid macular edema.

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