Comparison of two individualized treatment regimens with ranibizumab for diabetic macular edema.

Ebneter, Andreas; Waldmeier, Dominik; Zysset-Burri, Denise Corinne; Wolf, Sebastian; Zinkernagel, Martin (2017). Comparison of two individualized treatment regimens with ranibizumab for diabetic macular edema. Graefe's archive for clinical and experimental ophthalmology, 255(3), pp. 549-555. Springer 10.1007/s00417-016-3502-z

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PURPOSE To compare outcomes between an as-needed and a treat-and-extend regimen in managing diabetic macular edema with intravitreal ranibizumab. METHODS This was a retrospective, single-centre, comparative case series on 46 treatment naive patients with diabetic macular edema. Twenty-two patients were treated following an optical coherence tomography guided treat-and-extend protocol (OCTER), and 24 patients were treated according to a visual acuity guided pro re nata regimen (VAPRN) at a tertiarry referral centre. The main outcome measures were best-corrected visual acuity, central retinal thickness, and the number of ranibizumab injections, as well as visits after 12 months of treatment. RESULTS After 12 months, the mean gain in best-corrected visual acuity (± standard deviation) was 8.3 ± 6.7 versus 9.3 ± 8.9 letters in the VAPRN and OCTER group, respectively (p = 0.3). The mean decrease in central retinal thickness was 68.1 ± 88.0 μm in the VAPRN group and 117.6 ± 114.4 μm in the OCTER group (p = 0.2). The mean number of ranibizumab injections was significantly different between the VAPRN (5.9 ± 1.8) and the OCTER protocol (8.9 ± 2.0) (p < 0.001). CONCLUSION The visual acuity driven retreatment regimen resulted in a similar visual acuity outcome like optical coherence tomography guided retreatment for diabetic macular edema. Although the number of visits was similar in both groups, patients in the VAPRN group received significantly fewer intravitreal injections than patients in the OCTER group.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Zysset-Burri, Denise Corinne; Wolf, Sebastian and Zinkernagel, Martin


600 Technology > 610 Medicine & health








Sebastian Wolf

Date Deposited:

09 Jan 2017 14:27

Last Modified:

26 Feb 2017 01:30

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Anti-VEGF; Diabetic macular edema; Optical coherence tomography; Ranibizumab; Treatment burden; Treatment regimens




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