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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Cardiovascular involvement in patients with diabetic macular oedema treated with...
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Vol. 92. Issue 7.
Pages 302-306 (July 2017)
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Vol. 92. Issue 7.
Pages 302-306 (July 2017)
Original article
Cardiovascular involvement in patients with diabetic macular oedema treated with intravitreal ranibizumab in routine clinical practice
Afectación cardiovascular en pacientes con edema macular diabético tratados con ranibizumab intravítreo en la práctica clínica habitual
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R. Díaz-Rodrígueza,
Corresponding author
raquel.diazrguez@gmail.com

Corresponding author.
, R. Abreu-Gonzáleza, R. Dolz-Marcob,c, R. Gallego-Pinazob,c
a Servicio de Oftalmología, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
b Unidad de Mácula, Servicio de Oftalmología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
c RETICS RD160008 Enfermedades oculares, Prevención, detección precoz, tratamiento y rehabilitación de las patologías oculares, Valencia, Spain
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Figures (1)
Tables (3)
Table 1. Baseline epidemiological and metabolic characteristics of study patients.
Table 2. Distribution of CVA and AMI in different clinic trials.
Table 3. Distribution of the main exclusion criteria of the different studies.
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Abstract
Objective

To determine the cardiovascular events in naïve patients with diabetic macular oedema, before and after being treated with intravitreal ranibizumab.

Material and methods

A retrospective and descriptive study was conducted on patients with diabetic macular oedema and foveal involvement, who started treatment with intravitreal ranibizumab in 2014 in the Hospital Universitario Nuestra Señora de Candelaria and the Hospital Universitario y Politécnico La Fe. During the follow-up until August 2015, a record was made of parameters, including the prevalence and incidence of stroke and myocardial infarction.

Results

Among the 1324 intravitreal ranibizumab injections administered in 2014, only 159 of them corresponded to treatment initiation in 99 patients, with more than half requiring treatment of both eyes. The study patients included 58.4% males, in the 6th decade of life (mean=65.93±11.24 years), non-smokers (86.7%), type 2 diabetes (91.9%), hypertension (70.7%), and with dyslipidaemia (65.7%). Prior to treatment initiation, it was found that 6 patients (6.1%) suffered from an acute myocardial infarction, and 8 (8.1%) from stroke, and only one (1%) with post-stroke (p=0.039).

Conclusion

In our experience it seems that the intravitreal ranibizumab in diabetic macular oedema could be a safe alternative in patients with a history of stroke and myocardial infarction.

Keywords:
Intravitreal ranibizumab
Diabetic macular oedema
Systemic adverse events
Resumen
Objetivo

Analizar la afectación cardiovascular a corto plazo de los pacientes naïve con edema macular diabético, tratados con ranibizumab intravítreo, tanto pre- como postratamiento.

Material y métodos

Estudio retrospectivo y descriptivo de pacientes con edema macular diabético con afectación central, que hubieran iniciado tratamiento con ranibizumab intravítreo en 2014 en el Hospital Universitario Nuestra Señora de Candelaria y el Hospital Universitario y Politécnico La Fe. Se siguieron hasta agosto de 2015, estudiando, entre otras variables, la prevalencia e incidencia de accidente cerebrovascular y de infarto agudo de miocardio.

Resultados

De las 1.324 inyecciones de ranibizumab intravítreo que se administraron en 2014, solo 159 fueron como inicio de tratamiento, repartidas entre un total de 99 pacientes, ya que más de la mitad de ellos precisó tratamiento de ambos ojos (58,6%). El 58,4% de los pacientes fueron hombres, en la sexta década de la vida (X¯=65,93 años±11,24) y, en su mayoría, no fumadores (86,7%), diabéticos tipo 2 (91,9%), hipertensos (70,7%) y dislipidémicos (65,7%). Se encontraron 6 pacientes (6,1%) con infarto agudo de miocardio y 8 (8,1%) con accidentes cerebrovasculares (ACV) previos al inicio del tratamiento, y solo uno (1%) con accidente cerebrovascular posterior (p=0,039).

Conclusión

En nuestra experiencia el ranibizumab intravítreo en pacientes con edema macular diabético, con antecedentes de accidente cerebrovascular e infarto agudo de miocardio podría ser una alternativa segura.

Palabras clave:
Ranibizuamb intravítreo
Edema macular diabético
Eventos sistémicos adversos

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