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The newspaper of The Johns Hopkins University May 19, 2008 | Vol. 37 No. 35
Drug Therapy More Effective Against Diabetic Retinal Swelling

By John Lazarou
Johns Hopkins Medicine

Researchers at the Johns Hopkins Wilmer Eye Institute and 14 clinical centers around the United States have shown that the drug ranibizumab can reduce retinal thickness and improve the visual acuity of patients with diabetic macular edema, or DME, better than the current standard treatment, laser photocoagulation.

"The READ-2 study results are promising and show that ranibizumab injection into the eyes improves vision by resolving retinal thickening much better than laser photocoagulation," said Quan Dong Nguyen, an assistant professor of ophthalmology at Johns Hopkins' Wilmer Eye Institute.

Macular edema, one of the most common causes of blindness among working-age people, occurs when fluid and protein deposits collect on or under the macula of the eye, a yellow central area of the retina, causing it to thicken and swell.

The READ-2 (Ranibizumab for Edema of the mAcula in Diabetes phase 2) Study examined 126 diabetic patients with an average age of 62 years. The majority of participants had chronic DME with 20/80 vision. Patients were randomly assigned to one of three groups: ranibizumab injection alone, focal laser photocoagulation alone or a combination of ranibizumab injection plus focal laser photocoagulation. At each visit over the course of six months, patients were evaluated for vision, retinal thickening and general eye health. Although the study ended at six months, patients will be followed for two years.

Eyes treated with ranibizumab had a mean visual acuity of 20/63+3 at month six compared to a mean visual acuity of 20/80+2 in the laser group and 20/80+3 in the combination treatment group. In addition, eyes treated with ranibizumab had a 56 percent reduction in excess retinal thickness compared to only an 11 percent reduction in laser treated eyes.

"Although the results of this study are promising, a several-year-long phase 3 randomized trial is needed to determine the ultimate value of ranibizumab for patients with DME," Nguyen said. Two phase 3 trials currently are under way.

The research project is funded in part by Genentech; Nguyen is not a paid consultant.

The results of the study were presented at the 2008 Annual Meeting of the Association for Research in Vision and Ophthalmology, held April 27 to May 1 in Fort Lauderdale, Fla.


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