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A Novel Treatment for Proliferative Diabetic Retinopathy Anti–Vascular Endothelial Growth Factor Therapy

Jeffrey G. Gross, MD1; Adam R. Glassman, MS2
[+] Author Affiliations
1Carolina Retina Center, PA, Columbia, South Carolina
2Jaeb Center for Health Research, Tampa, Florida
JAMA Ophthalmol. 2016;134(1):13-14. doi:10.1001/jamaophthalmol.2015.5079.
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This Viewpoint discusses the Diabetic Retinopathy Clinical Research Network randomized trial comparing ranibizumab vs panretinal photocoagulation for proliferative diabetic retinopathy in eyes with or without diabetic macular edema.

For nearly 40 years, panretinal photocoagulation (PRP) has been the standard treatment for proliferative diabetic retinopathy (PDR).1 Eyes responding to PRP can remain stable for decades, although incomplete responses and relapses can occur. Although remarkably effective at reducing the risk of ambulatory vision loss (<5/200), PRP destroys viable peripheral retinal tissue resulting in peripheral visual field loss and possible exacerbation of macular edema. Therefore, evaluating new and less destructive therapeutic alternatives, such as anti–vascular endothelial growth factor (anti-VEGF) therapy, is desirable. Several studies using anti-VEGF for diabetic macular edema (DME) have reported improvement of retinal neovascularization (NV)2,3; until now, it was unclear if these beneficial effects could be sustained on eyes with PDR when compared with PRP.


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