Retinopathy is a major complication of both type 1 and type 2 diabetes and can lead to vision problems, including blindness. A symptom of diabetic retinopathy is macular edema, in which fluid leaks into the macula—the part of the retina that provides sharp central vision—and the retina swells with the fluid. Macular edema causes blurred vision. Until now, macular edema has been treated with laser surgery. The Food and Drug Administration (FDA) has now approved ranibizumab injection (Lucentis) for the treatment of diabetic macular edema. Ranibizumab is a recombinant human monoclonal antibody that reduces endothelial cell proliferation, vascular leakage, and new blood vessel formation. The drug was already approved for treating wet (neovascular) age-related macular degeneration and macular edema after retinal vein occlusion. An intravitreal injection of ranibizumab is administered monthly by a health care provider to treat diabetic macular edema. In clinical trials, between 34% and 45% of those treated with the drug gained at least three lines of vision on an eye chart, compared with 12% to 18% of those who didn't receive the drug.
Common adverse effects of ranibizumab include bleeding into the conjunctiva, eye pain, eye floaters, and increased intraocular pressure. Nurses who work with diabetic patients should provide education regarding the importance of yearly comprehensive eye examinations, in which macular edema and diabetic retinopathy can be detected. The yearly examination is important because there may be no symptoms in the early stages of macular edema. If the patient experiences blurred vision or floaters, she or he should be instructed to see an ophthalmologist as soon as possible. To read the FDA news release regarding ranibizumab, go to http://1.usa.gov/P3pm9a.