Macular edema ranibizumab

The FDA approved intraocular injections include miotics, triamcinolone acetonide, pegaptanib sodium, ranibizumab, formivirsen sodium, viscoelastics and viscoadherents, and an antiviral agent for intravitreal injection. There are many small and large molecules currently in clinical trials that are delivered via intravitreal injection for the treatment of a variety of retinal diseases with a large area of focus on the treatment of AMD and macular edema. 

Chun DW, Heier JS, Topping TM et al. A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant macular edema. Ophthalmology 2006 113(10) 1706-1712. 

In an open, prospective, uncontrolled study, 10 patients with macular edema due to central retinal vein occlusion were randomly assigned to ranibizumab 0.3 or 0.5 mg and adverse reactions were studied [6. There were no severe adverse events. 

In a randomized controlled trial in patients with diabetic macular edema who were randomised to intravitreal ranibizumab 0.5 mg, focal or grid laser, and a combination of these interventions, there was one serious adverse event (a stroke in a high-risk patient), which was presumed to be unrelated to the use of ranibizumab because it occurred 6 weeks after the injection [10 ]. There was no difference in blood pressure. Eight patients across the groups had vitreous hemorrhages, and in one patient it was combined with worsening of the macular edema, while in the others it was mild and had cleared at 6 months. 

Pieramici DJ, Rabena M, Castellarin AA, Nasir M, See R, Norton T, Sanchez A, Risard S, Avery RL. Ranibizumab for the treatment of macular edema associated with perfused central retinal vein occlusions. Ophthalmology 2008 115 e47-54. 

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