The Influence of Systemic Factors on Diabetic Macular Edema and Visual Outcomes Post Intravitreal Anti-Vascular Endothelial Growth Factor Injection

Abstract Objective: To assess the influence of systemic factors on the response to ranibizumab injection in terms of reduction in diabetic macular edema and visual outcome. Materials and Methods: This study included 87 eyes of patients with diabetic macular edema. The effect of systemic factors on change in vision and macular edema one month post ranibizumab was assessed. Systemic factors, including diabetes duration, hypertension, nephropathy, ischemic heart disease, glycosylated hemoglobin, hemoglobin, low-density lipoprotein, high-density lipoprotein, triglycerides, and serum creatinine, were recorded. A student’s t -test was used to assess the effect of systemic factors on the change in central foveal thickness and vision. To predict the risk factors influencing the outcome of injection, multivariate linear regression was used. P <0.05 was considered significant. Result: Diabetic macular edema with associated hypertension ( P = 0.01), nephropathy ( P = 0.02), heart disease ( P = 0.04), and duration of diabetes more than 10 years ( P = 0.03) were associated with poorer visual outcomes post ranibizumab, but there was no significant difference in improvement of central foveal thickness based on systemic factors. Conclusion: Patients with macular edema should be informed of the prognosis post-injection based on the presence or absence of the above-associated factors. Strict control of systemic comorbidities to be advised for better anti-VEGF outcomes.