Vascular Endothelial Growth Factor Is a Critical Stimulus for Diabetic Macular Edema

Quan Dong Nguyen, Sinan Tatlipinar, Syed Mahmood Shah, Julia A. Haller, Edward Quinlan, Jennifer Sung, Ingrid Zimmer-Galler, Diana V. Do, Peter A. Campochiaro

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Abstract

Purpose: The role of vascular endothelial growth factor (VEGF) in diabetic macular edema (DME) was tested with ranibizumab, a specific antagonist of VEGF. Design: A nonrandomized clinical trial. Methods: Ten patients with chronic DME received intraocular injections of 0.5 mg of ranibizumab at baseline and at one, two, four, and six months. The primary outcome was change in foveal thickness between baseline and seven months, and the secondary outcome measures were changes from baseline in visual acuity and macular volume. Results: Mean values at baseline were 503 μm for foveal thickness, 9.22 mm3 for macular volume, and 28.1 letters (20/80) read on an Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. At seven months (one month after the fifth injection), the mean foveal thickness was 257 μm, which was a reduction of 246 μm (85% of the excess foveal thickness present at baseline; P = .005 by Wilcoxon signed-rank test for likelihood that this change is due to ranibizumab rather than chance). The macular volume was 7.47 mm3, which was a reduction of 1.75 mm3 (77% of the excess macular volume at baseline; P = .009). Mean visual acuity was 40.4 letters (20/40), which was an improvement of 12.3 letters (P = .005). The injections were well-tolerated with no ocular or systemic adverse events. Conclusion: Intraocular injections of ranibizumab significantly reduced foveal thickness and improved visual acuity in 10 patients with DME, which demonstrated that VEGF is an important therapeutic target for DME. A randomized, controlled, double-masked trial is needed to test whether intraocular injections of ranibizumab provide long-term benefit to patients with DME.

Original languageEnglish (US)
Pages (from-to)961-969.e4
JournalAmerican journal of ophthalmology
Volume142
Issue number6
DOIs
StatePublished - Dec 2006

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Macular Edema
Vascular Endothelial Growth Factor A
Intraocular Injections
Visual Acuity
Injections
Diabetic Retinopathy
Nonparametric Statistics
Outcome Assessment (Health Care)
Ranibizumab
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Nguyen, Q. D., Tatlipinar, S., Shah, S. M., Haller, J. A., Quinlan, E., Sung, J., ... Campochiaro, P. A. (2006). Vascular Endothelial Growth Factor Is a Critical Stimulus for Diabetic Macular Edema. American journal of ophthalmology, 142(6), 961-969.e4. https://doi.org/10.1016/j.ajo.2006.06.068

Vascular Endothelial Growth Factor Is a Critical Stimulus for Diabetic Macular Edema. / Nguyen, Quan Dong; Tatlipinar, Sinan; Shah, Syed Mahmood; Haller, Julia A.; Quinlan, Edward; Sung, Jennifer; Zimmer-Galler, Ingrid; Do, Diana V.; Campochiaro, Peter A.

In: American journal of ophthalmology, Vol. 142, No. 6, 12.2006, p. 961-969.e4.

Research output: Contribution to journalArticle

Nguyen, QD, Tatlipinar, S, Shah, SM, Haller, JA, Quinlan, E, Sung, J, Zimmer-Galler, I, Do, DV & Campochiaro, PA 2006, 'Vascular Endothelial Growth Factor Is a Critical Stimulus for Diabetic Macular Edema', American journal of ophthalmology, vol. 142, no. 6, pp. 961-969.e4. https://doi.org/10.1016/j.ajo.2006.06.068
Nguyen, Quan Dong ; Tatlipinar, Sinan ; Shah, Syed Mahmood ; Haller, Julia A. ; Quinlan, Edward ; Sung, Jennifer ; Zimmer-Galler, Ingrid ; Do, Diana V. ; Campochiaro, Peter A. / Vascular Endothelial Growth Factor Is a Critical Stimulus for Diabetic Macular Edema. In: American journal of ophthalmology. 2006 ; Vol. 142, No. 6. pp. 961-969.e4.
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abstract = "Purpose: The role of vascular endothelial growth factor (VEGF) in diabetic macular edema (DME) was tested with ranibizumab, a specific antagonist of VEGF. Design: A nonrandomized clinical trial. Methods: Ten patients with chronic DME received intraocular injections of 0.5 mg of ranibizumab at baseline and at one, two, four, and six months. The primary outcome was change in foveal thickness between baseline and seven months, and the secondary outcome measures were changes from baseline in visual acuity and macular volume. Results: Mean values at baseline were 503 μm for foveal thickness, 9.22 mm3 for macular volume, and 28.1 letters (20/80) read on an Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. At seven months (one month after the fifth injection), the mean foveal thickness was 257 μm, which was a reduction of 246 μm (85{\%} of the excess foveal thickness present at baseline; P = .005 by Wilcoxon signed-rank test for likelihood that this change is due to ranibizumab rather than chance). The macular volume was 7.47 mm3, which was a reduction of 1.75 mm3 (77{\%} of the excess macular volume at baseline; P = .009). Mean visual acuity was 40.4 letters (20/40), which was an improvement of 12.3 letters (P = .005). The injections were well-tolerated with no ocular or systemic adverse events. Conclusion: Intraocular injections of ranibizumab significantly reduced foveal thickness and improved visual acuity in 10 patients with DME, which demonstrated that VEGF is an important therapeutic target for DME. A randomized, controlled, double-masked trial is needed to test whether intraocular injections of ranibizumab provide long-term benefit to patients with DME.",
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AU - Quinlan, Edward

AU - Sung, Jennifer

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AB - Purpose: The role of vascular endothelial growth factor (VEGF) in diabetic macular edema (DME) was tested with ranibizumab, a specific antagonist of VEGF. Design: A nonrandomized clinical trial. Methods: Ten patients with chronic DME received intraocular injections of 0.5 mg of ranibizumab at baseline and at one, two, four, and six months. The primary outcome was change in foveal thickness between baseline and seven months, and the secondary outcome measures were changes from baseline in visual acuity and macular volume. Results: Mean values at baseline were 503 μm for foveal thickness, 9.22 mm3 for macular volume, and 28.1 letters (20/80) read on an Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. At seven months (one month after the fifth injection), the mean foveal thickness was 257 μm, which was a reduction of 246 μm (85% of the excess foveal thickness present at baseline; P = .005 by Wilcoxon signed-rank test for likelihood that this change is due to ranibizumab rather than chance). The macular volume was 7.47 mm3, which was a reduction of 1.75 mm3 (77% of the excess macular volume at baseline; P = .009). Mean visual acuity was 40.4 letters (20/40), which was an improvement of 12.3 letters (P = .005). The injections were well-tolerated with no ocular or systemic adverse events. Conclusion: Intraocular injections of ranibizumab significantly reduced foveal thickness and improved visual acuity in 10 patients with DME, which demonstrated that VEGF is an important therapeutic target for DME. A randomized, controlled, double-masked trial is needed to test whether intraocular injections of ranibizumab provide long-term benefit to patients with DME.

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