Title: Comparative Study of Intravitreal Ranibizumab with and Without Nepafenac Eye Drops for Center Involving Diabetic Macular Edema

Authors: Mohsen Abou Shousha MD, Hany Ahmed Helaly MD

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i10.21

Abstract

Purpose: to compare intravitreal ranibizumab with and without Nepafenac eye drops as a treatment for center involving diabetic macular edema.

Methods:This is a randomized, comparative, double masked, interventional prospective clinical study that included 60 eyes with center involving diabetic macular edema and had good metabolic control, randomly assigned into 2 groups (A and B). Patients had monthly intra-vitreal injection of 0.5 mg ranibizumab (Lucentis; Novartis, Basel, Switzerland and Genentech Inc., South San Francisco, CA) for the first three months. In the next nine months, reinjection was done according to predetermined reinjection criteria. Group B had in addition topical Nepafenac eye drops 0.1% (Nevanac; Alcon Labs, Fort Worth, TX, USA), three times daily for twelve months.

Results:As regards the mean central macular thickness (CMT) at 12 months, it was 320 + 63 microns and 310 + 71 microns for group A and B respectively (p = 0.311). The mean number of injections in the 12 months follow up period was 6.9 + 1.1 (range from 5 to 9) and 5.9 + 1.18 (range from 4 to 8) for group A and group B respectively (p = 0.002).

Conclusion:Nepafenac 0.1% eye drops three times daily may be a good adjuvant to intravitreal ranibizumab in the treatment of diabetic macular edema that decrease the number of ranibizumab injections needed for those patients.

Keywords: Diabetic Macular Edema, Nepafenac, Ranibizumab, Lucentis; Intravitreal Injection.

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