Outcome and Predictors for 2-Year Visual Acuity in Eyes with Diabetic Macular Edema Treated with Ranibizumab

Abstract Purpose: To determine the role of baseline characteristics in predicting visual outcome in patients with diabetic macular edema (DME) treated with ranibizumab. Methods: A review was carried out of the charts of 97 eyes that received pro re nata (PRN) intravitreal ranibizumab (IR) 0.5 mg treatment for DME. The change in the mean best-corrected visual acuity (BCVA) was analyzed. The baseline demographics and ocular and optic coherence tomography findings were analyzed to determine the association with the 2-year visual acuity (VA). Results: BCVA increased from 0.54 ± 0.2 (0.05–1.0) to 0.41 ± 0.3 (0.0–1.0) log of the minimum angle of resolution ( P < 0.001). Age ( P = 0.012), gender ( P = 0.018), baseline BCVA ( P < 0.001), presence of leaking microaneurysms (MA) ( P = 0.018), development of vitreomacular traction (VMT) ( P = 0.001), development of posterior vitreous detachment (PVD) ( P = 0.040), and disruption of ellipsoid zone (EZ) ( P = 0.007) were found as predictors of 2-year VA. There was no association between visual outcome and the other characteristics. Conclusions: PRN treatment of IR provides significant benefits in VA gain and anatomic improvement in eyes with DME. Older age, female sex, lower baseline VA, VMT development, and EZ disruption are predictors for the poor final VA. Development of PVD and leaking MA are predictors for the good final VA.