[Recommendations for the use of ranibizumab in diabetic macular edema at IMSS].

{"article_title":"[Recommendations for the use of ranibizumab in diabetic macular edema at IMSS].","author":"Ortiz-Lerma R, Gonz\u00e1lez-Cervantes CP, Hern\u00e1ndez-N\u00fa\u00f1ez F, Ancona-Dur\u00e1n I, Betesh-Rodr\u00edguez I, M\u00e9ndez N, Garza-Cant\u00fa D, L\u00f3pez-Mart\u00ednez \u00d3, Mart\u00ednez-Ruiz AM, L\u00f3pez-Montero LM, Mu\u00f1oz A, Blancas-Ontiveros JA, Fern\u00e1ndez-Trejo CM, Mayorga-Rubalcava JC, Flores-G\u00f3ngora SE, G\u00f3mez-Galv\u00e1n JL, Dom\u00ednguez-\u00c1lvarez PA, S\u00e1nchez-Hern\u00e1ndez E, Cant\u00fa-Yeverinon H","journal_title":"Revista medica del Instituto Mexicano del Seguro Social","issn":"2448-5667","isbn":"","publication_date":"2020","volume":"55","issue":"6","first_page":"758","page_count":"","accession_number":"29190870","doi":"","publisher":"Coordinacio\u0301n de Educacio\u0301n en Salud, Divisio\u0301n de Innovacio\u0301n Educativa","doctype":"Journal Article","subjects":"Angiogenesis Inhibitors administration & dosage; Diabetic Retinopathy drug therapy; Macular Edema drug therapy; Ranibizumab administration & dosage; Academies and Institutes; Angiogenesis Inhibitors therapeutic use; Diabetic Retinopathy diagnosis; Diabetic Retinopathy physiopathology; Drug Administration Schedule; Humans; Intravitreal Injections; Macular Edema diagnosis; Macular Edema etiology; Mexico; National Health Programs; Ranibizumab therapeutic use; Social Security","interest_area":["Ophthalmology"," Endocrinology"," Internal Medicine"],"abstract":"Diabetic macular edema can occur at any stage of diabetic retinopathy. It represents the main cause of vision loss in diabetes type I and II with a prevalence of 3-10% in diabetic patients of the Instituto Mexicano del Seguro Social (IMSS). Our aim is to elaborate treatment guidelines and provide recommendations for the use of intravitreal ranibizumab for diabetic medical edema at IMSS. Nine retina specialists and 10 ophthalmologists from IMSS high specialty medical units gathered to discuss the bibliographic evidence for the safety and efficacy of ranibizumab for this disease, in order to create consensus on its use in the institution. Intravitreal ranibizumab injection should be used on patients presenting diffuse or cystic diabetic macular edema who have strict metabolic control and visual acuity between 20\/30 and 20\/200 ETDRS, as well as structural features, such as inferior foveal limit of 280 \u03bcm and ischemic areas no larger than 50% of the central foveal area. Treatment regime should consist of a loading charge of three monthly injections of ranibizumab 0.5 mg, followed by monthly follow-ups and treatment as needed according to anatomic and functional criteria. This consensus decision-making process on the criteria to treat and re-treat patients with this drug will result in better health outcomes than those currently observed among patients with diabetic macular edema at IMSS.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=29190870&authtype=shib&custid=ns346513&group=main&profile=eds","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Ortiz-Lerma R, Gonz\u00e1lez-Cervantes CP, Hern\u00e1ndez-N\u00fa\u00f1ez F, Ancona-Dur\u00e1n I, Betesh-Rodr\u00edguez I, M\u00e9ndez N, Garza-Cant\u00fa D, L\u00f3pez-Mart\u00ednez \u00d3, Mart\u00ednez-Ruiz AM, L\u00f3pez-Montero LM, Mu\u00f1oz A, Blancas-Ontiveros JA, Fern\u00e1ndez-Trejo CM, Mayorga-Rubalcava JC, Flores-G\u00f3ngora SE, G\u00f3mez-Galv\u00e1n JL, Dom\u00ednguez-\u00c1lvarez PA, S\u00e1nchez-Hern\u00e1ndez E, Cant\u00fa-Yeverinon H","Journal_Info":"Publisher: Coordinacio\u0301n de Educacio\u0301n en Salud, Divisio\u0301n de Innovacio\u0301n Educativa Country of Publication: Mexico NLM ID: 101243727 Publication Model: Print Cited Medium: Internet ISSN: 2448-5667 (Electronic) Linking ISSN: 04435117 NLM ISO Abbreviation: Rev Med Inst Mex Seguro Soc Subsets: MEDLINE","Publication_Type":"Journal Article; Practice Guideline","Published_Date":"2017-11-01","Source":"Revista medica del Instituto Mexicano del Seguro Social [Rev Med Inst Mex Seguro Soc] 2017 Nov-Dec; Vol. 55 (6), pp. 758-767.","Languages":"Spanish; Castilian","Electronic_ISSN":"2448-5667","MeSH_Terms":"Angiogenesis Inhibitors\/*administration & dosage , Diabetic Retinopathy\/*drug therapy , Macular Edema\/*drug therapy , Ranibizumab\/*administration & dosage, Academies and Institutes ; Angiogenesis Inhibitors\/therapeutic use ; Diabetic Retinopathy\/diagnosis ; Diabetic Retinopathy\/physiopathology ; Drug Administration Schedule ; Humans ; Intravitreal Injections ; Macular Edema\/diagnosis ; Macular Edema\/etiology ; Mexico ; National Health Programs ; Ranibizumab\/therapeutic use ; Social Security","Subjects":"Academies and Institutes, Angiogenesis Inhibitors therapeutic use, Diabetic Retinopathy diagnosis, Diabetic Retinopathy physiopathology, Drug Administration Schedule, Humans, Intravitreal Injections, Macular Edema diagnosis, Macular Edema etiology, Mexico, National Health Programs, Ranibizumab therapeutic use, Social Security, Angiogenesis Inhibitors administration & dosage, Diabetic Retinopathy drug therapy, Macular Edema drug therapy, Ranibizumab administration & dosage","Title_Abbreviations":"Revista medica del Instituto Mexicano del Seguro Social","Volume":"55"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"29190870","RelevancyScore":"829","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"828.832397460938"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=29190870&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=29190870&authtype=shib&custid=ns346513&group=main&profile=eds"}