Visual Impairment and Blindness Avoided with Ranibizumab in Hispanic and Non-Hispanic Whites with Diabetic Macular Edema in the United States.

Abstract

OBJECTIVE:

To estimate visual impairment (VI) and blindness avoided with intravitreal ranibizumab 0.3 mg treatment for central-involved diabetic macular edema (DME) among Hispanic and non-Hispanic white individuals in the United States.

DESIGN:

Population-based model simulating visual acuity (VA) outcomes over 2 years after diagnosis and treatment of DME.

PARTICIPANTS:

Visual acuity changes with and without ranibizumab were based on data from the RISE, RIDE, and DRCR Network trials.

METHODS:

For the better-seeing eye, VA outcomes included VI, defined as worse than 20/40 in the better-seeing eye, and blindness, defined as VA of 20/200 or worse in the better-seeing eye. Incidence of 1 or both eyes with central-involved DME in 2010 were estimated based on the 2010 United States population, prevalence of diabetes mellitus, and 1-year central-involved DME incidence rate. Sixty-one percent of incident individuals had bilateral DME and 39% had unilateral DME, but DME could develop in the fellow eye.

MAIN OUTCOMES MEASURES:

Cases of VI and blindness avoided with ranibizumab treatment.

RESULTS:

Among approximately 102 million Hispanic and non-Hispanic white individuals in the United States 45 years of age and older in 2010, an estimated 37 274 had central-involved DME and VI eligible for ranibizumab treatment. Compared with no ranibizumab treatment, the model predicted that ranibizumab 0.3 mg every 4 weeks would reduce the number of individuals with VI from 11 438 (95% simulation interval [SI], 7249-16 077) to 6304 (95% SI, 3921-8981), a 45% (95% SI, 36%-53%) reduction at 2 years. Ranibizumab would reduce the number of incident eyes with VA worse than 20/40 from 16 910 (95% SI, 10 729-23 577) to 9361 (95% SI, 5839-13 245), a 45% (95% SI, 38%-51%) reduction. Ranibizumab was estimated to reduce the number of individuals with legal blindness by 75% (95% SI, 58%-88%) and the number of incident eyes with VA of 20/200 or worse by 76% (95% SI, 63%-87%).

CONCLUSIONS:

This model suggests that ranibizumab 0.3 mg every 4 weeks substantially reduces prevalence of VI and legal blindness 2 years after initiating treatment among Hispanic and non-Hispanic white individuals in the United States with central-involved DME that has caused vision loss.

• Authors: Rohit Varma, Neil M Bressler, Quan V Doan, Mark Danese, Chantal M Dolan, Abraham Lee, Adam Turpcu
• Journal: Ophthalmology (Ophthalmology) Vol. 122 Issue 5 Pg. 982-9 (May 2015) ISSN: 1549-4713 [Electronic] United States
• PMID: 25670501 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Ranibizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Blindness (ethnology, prevention & control)
• Diabetic Retinopathy (drug therapy, ethnology)
• Female
• Hispanic or Latino (ethnology)
• Humans
• Intravitreal Injections
• Macular Edema (drug therapy, ethnology)
• Male
• Middle Aged
• Models, Statistical
• Ranibizumab
• United States (epidemiology)
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Vision, Low (ethnology, prevention & control)
• Visual Acuity (physiology)
• Visually Impaired Persons (statistics & numerical data)
• White People (ethnology)