Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not ranibizumab improves best corrected visual acuity (BCVA) in adults with diabetic macular edema compared to patients who do not receive ranibizumab.

STUDY DESIGN: The selective review examined best corrected visual acuity values reported from published, primary literature sources that examined the efficacy of ranibizumab in diabetic macular edema.

DATA SOURCES: Two double blind randomized controlled trials and one case control study were selected and reviewed.

OUTCOMES MEASURED: Best corrected visual acuity (BCVA) as measured from Early Treatment Diabetic Retinopathy Study visual acuity charts, which were converted to dichotomous data to determine treatment effects. Adverse events were also considered in this selective review to determine safety of this therapeutic intervention.

RESULTS: Mean BCVA improvements were 10.3, 9, and 13 with all p-values < 0.05 compared to statistically significant decline in acuity in control arms. Adverse event rates were notably higher in therapeutic arms but only a minority was serious adverse events (SAE).

CONCLUSION: All reported increases in BCVA suggests that indeed ranibizumab is an effective therapeutic option for diabetic macular edema but requires continued investigation to further elaborate its safety profile outside a controlled research setting.