Ranibizumab for idiopathic epiretinal membranes: A retrospective case series

Abstract

Purpose: To study the effect of intravitreal ranibizumab on idiopathic epiretinal membranes (ERMs).

Methods: A retrospective cohort study on a consecutive series of ranibizumab intravitreal injections for epiretinal membranes was performed. Four cases were identified by reviewing a claims database linked to electronic medical records. All patients received a total of three 0.05 mg/0.05 ml ranibizumab intravitreal injections at a monthly interval. The primary outcome measure was the final best-corrected visual acuity (BCVA) at the end of the injection series, and the final central macular thickness (CMT).

Results: All four patients completed 3 months follow-up after the last ranibizumab injection. The mean baseline CMT was 509 microns (SD = 111). A trend was noticed for reduction in CMT (Δ = 41 microns) P = 0.08. Three patients improved by one line in their BCVA. The remaining patient maintained the same BCVA. No complications were noted.

Conclusion: In this study, intravitreal injection of ranibizumab marginally reduced retinal thickness in four patients with minimal improvement in visual acuity. No safety concerns were noticed. Further basic science and clinical studies may be warranted to assess the role of vascular endothelial growth factor and the effect of ranibizumab on idiopathic epiretinal membranes.

Keywords: Epiretinal membrane; Intravitreal injection; Metamorphopsia; Ranibizumab; Vascular endothelial growth factor.

Figure 1

Optical coherence tomography (OCT) for Patient 1 showing reduction in central macular thickness after ranibizumab injections by 45 microns (left, before treatment; right, three months after third injection). Note the disappearance of the central macular cyst.

Figure 2

OCT images showing reduction of CMT by 82 microns and shrinking of cystoid spaces in Patient 3.