Frequent Dosing Regimen of Lucentis for Subjects With Persistent Diabetic Macular Edema Despite Standard antiVEGF Dosing

This is an open-label, subject masked, phase II study of intravitreally administered
ranibizumab in subjects with persistent diabetic macular edema. Persistent diabetic macular
edema is defined as subjects who still have central subfield thickness on SD-OCT of greater
than 320 microns after having received at least 3 previous doses of AntiVEGF therapy in the
past 5 months. Consented, enrolled subjects will be randomized into two subgroups: (1)
standard dosing of monthly 0.3mg ranibizumab or (2) 0.3mg ranibizumab given 2 weeks apart
for 5 doses followed by monthly dosing.

Inclusion Criteria:

Subjects will be eligible if the following criteria are met:

- Ability to provide written informed consent and comply with study assessments for the
full duration of the study

- Age >18 years

- Diagnosis of Type 1 or Type 2 diabetes

- BCVA score using the ETDRS method of >24 and <78 in the study eye at the screening
visit

- 3 or more intravitreal injections of AntiVEGF over the 5 months prior to screening

- Presence of diabetic macular edema defined as SD-OCT CST >320 microns on spectral
domain machine

Exclusion Criteria:

- Subjects who meet any of the following criteria will be excluded from this study:

- Anti-VEGF treatment in the study eye within 3 weeks prior to screening

- Intravitreal Ozurdex treatment in the study eye within 12 weeks prior to
screening

- Intravitreal steroid treatment in the study eye within 8 weeks prior to
screening

- PRP or focal laser in the study eye within 4 months prior to screening

- Active iris neovascularization in the study eye

- Any ocular condition in the study eye that, in the opinion of the investigator,
is severe enough to compromise the study result.

- History of cataract surgery in the study eye within 3 months prior to screening
visit

- Uncontrolled systemic disease

- Current enrollment in an investigational drug study or participation in such a
study within 30 days prior to the screening visit

- Female patients who are pregnant, nursing or planning a pregnancy or who are of
childbearing potential and not using a reliable means of contraception.

- Any condition or reason (including inability to read ETDRS chart or language
barrier) that precludes the patient's ability to comply with study requirements
including completion of the study.

- Known allergy, hypersensitivity or contraindication to the study medications,
its components, fluorescein or povidone iodine.