Effect of Intravitreal Injection of Ranibizumab on Diabetic Macular Oedema at a Tertiary Centre in West Bengal: A Prospective Study

Introduction: Diabetic Retinopathy (DR) is one among the many causes of visual loss in people all over the world. Diabetic Macular Oedema (DME) is the most common among vision threatening complications of DR, with a major impact on quality of life of the patient. The intravitreal ranibizumab injection (anti Vascular Endothelial Growth Factor (VEGF), which prevents neovascularisation, is given monthly with approved dose of 0.3/0.5 mg with or without laser in the option of choice for all cases of central involving macular oedema.

Aim: To find out the effectiveness of injection ranibizumab on patients with DME and to provide the better line of treatment for DME patients.

Materials and Methods: This prospective study with quasi-experimental design constituted all the Type I and II Diabetic patients attending Out Patient Department (OPD) in College of Medicine and JNM Hospital, West Bengal, India from December 2019 to January 2021. Spectral Domain Optical Coherence Tomography (SD-OCT) images were obtained and used to diagnose macular oedema. Intravitreal injection ranibizumab (0.5 mg) was given as a standard treatment protocol with a dose interval of one month to all the DME patients. Foveal Thickness (FT) and Visual Acuity (VA) were evaluated before and after one month of injection. The t-test was used to compare the mean value of Central Macular Thickness (CMT) before and after intervention, p<0.05 was considered for statistical significance.

Results: In the current study, (n=105), mean age of the population was 55.1 years and gender distribution being: females- 54 (51.4%) and males- 51 (48.6%). Mean duration of diabetes was 10.7 years. CMT value significantly decreased from mean of 416.0095 to 383.8667 after injection. The mean LogMAR value significantly decreased from 1.0350 to 0.8625 after injection. Positive correlation was found between LogMAR after treatment with CMT (r-0.857; p-value <0.0001).

Conclusion: Single dose of 0.5mg of intravitreal injection of ranibizumab is effective in decreasing the CMT and improving VA in patients with DME.