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Journal of Ophthalmology
Volume 2017, Article ID 4834201, 8 pages
Research Article

Systemic Associations with Residual Subretinal Fluid after Ranibizumab in Diabetic Macular Edema

1Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
2Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

Correspondence should be addressed to Meng-Ju Tsai; moc.liamtoh@9290regor

Received 21 April 2017; Revised 9 June 2017; Accepted 9 July 2017; Published 27 July 2017

Academic Editor: Enrico Peiretti

Copyright © 2017 Meng-Ju Tsai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To investigate the impact of systemic diseases on the occurrence of subretinal fluid (SRF) in diabetic macular edema (DME) and prognostic factors for residual SRF following three consecutive monthly intravitreal ranibizumab. Methods. Ninety-seven eyes from 68 patients with DME who completed 3 consecutive monthly injections of ranibizumab were enrolled. Systemic parameters mainly included chronic kidney disease (CKD), hypertension, HbA1c, and insulin dependence. Renal parameters for CKD were serum creatinine, estimated glomerular filtration rate (eGFR), and serum albumin. Ocular factors were baseline central macular thickness (CMT), severity of diabetic retinopathy (DR), and status of panretinal photocoagulation (PRP). Results. Chronic kidney disease had significant correlation with baseline SRF (, after partial correlation with adjustment for age and DR severity). As for CKD, lower serum albumin, but not eGFR or serum creatinine, was associated with baseline presence of SRF (, and , resp., after adjustment for age and DR severity). Overall, lower eGFR and lower HbA1c values, contrary to popular belief, predicted the presence of residual SRF following intravitreal injections ( and , resp.). Conclusions. Tight sugar control and poorer baseline kidney function may slow the resorption of SRF after anti-VEGF injections in patients with DME in the short term.