Journal of Medicine and Applied Clinical Sciences | Volume 2 Issue 1 | Pages: 68-81 | Doi : 10.67914/jmacs/rsa/2.1/68-81

Research Article

OPEN ACCESS | Published on : 30-Jun-2026

Short-Term Visual, Anatomical, and Ocular Safety Outcomes Following Three Monthly Intravitreal Ranibizumab Injections in Diabetic Macular Edema: A Retrospective Observational Study

• Ankit Sanjay Varshney
• Associate Professor, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Surat, India.

Anushka A. Singh
• Master of Optometry student, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Surat, India.

Chetna Patel
• Professor, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Surat, India.

Mahendrasinh D. Chauhan
• Principal, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Surat, India.

Darshana Patel
• Assistant Professor, Department of Optometry, Shree Bharatimaiya College of Optometry & Physiotherapy, Surat, India.

Abstract

Background: Diabetic macular edema (DME) is an important cause of visual impairment associated with diabetic retinopathy. Although intravitreal ranibizumab is an established treatment for DME, outcomes observed in routine clinical settings may vary from those reported in controlled trials. Assessment of treatment response should therefore consider functional vision, retinal morphology, and short-term ocular safety together. Objective: To examine longitudinal changes in distance and near visual acuity, central macular thickness (CMT), and intraocular pressure (IOP) during the first 12 weeks following a three-dose monthly course of intravitreal ranibizumab in patients with DME.

Methods: Medical records of patients treated for DME at a tertiary vitreoretinal referral center in India between June 2022 and November 2024 were retrospectively reviewed. The analysis included 50 eyes belonging to 45 patients who received three consecutive monthly intravitreal ranibizumab injections. Best-corrected distance visual acuity (BCDVA), best-corrected near visual acuity (BCNVA), OCT-derived CMT, and IOP were documented before treatment and at approximately 4, 8, and 12 weeks. Longitudinal changes in these parameters were evaluated statistically across the observation period.

Results: During follow-up, mean BCDVA improved from 0.562 ± 0.305 logMAR at baseline to 0.246 ± 0.163 logMAR at Week 12. Mean BCNVA similarly changed from 0.806 ± 0.295 to 0.454 ± 0.146 logMAR. Retinal thickness also decreased progressively, with mean CMT falling from 482.84 ± 85.99 μm at baseline to 292.52 ± 46.46 μm at Week 12. Significant longitudinal changes were identified for BCDVA, BCNVA, and CMT (all p < 0.001), with large time-associated effects for both visual acuity measures and a very large effect for CMT. Mean IOP increased from 15.90 ± 2.79 mmHg to 16.92 ± 2.36 mmHg over the same period (p = 0.0037); however, no sustained ocular hypertension requiring treatment or sight-threatening injection-related complication was recorded.

Conclusion: A three-monthly-injection course of ranibizumab was accompanied by meaningful short-term functional and anatomical improvement in this real-world DME cohort. The modest rise in IOP was not associated with clinically important short-term ocular hypertension. Because the study was retrospective, single-center, and lacked an untreated comparison group, the observed changes cannot be attributed exclusively to ranibizumab. Prospective studies involving larger populations and longer observation are required to establish the persistence of treatment response and longer-term ocular safety.

Keywords

Diabetic macular edema, Ranibizumab, Intravitreal anti-VEGF therapy, Diabetic retinopathy, Visual acuity, Central macular thickness, Optical coherence tomography, Intraocular pressure

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