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DRCR.net PROTOCOL S: Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy

July 24, 2018

Clinical trial

Five-Year Outcomes of Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial.

Gross JG, Glassman AR, Liu D, Sun JK, Antoszyk AN, Baker CW, Bressler NM, Elman MJ, Ferris FL 3rd, Gardner TW, Jampol LM, Martin DF, Melia M, Stockdale CR, Beck RW.

JAMA Ophthalmol. 2018 Oct 1;136(10):1138-1148.
Full text | Metrics.

Main finding: Severe vision loss or serious complications of PDR were uncommon with Panretinal photocoagulation or ranibizumab, although the ranibizumab group had lower rates of developing diabetic macular edema and less visual field loss. Patient-specific factors such as compliance and cost should be considered in the choice of treatment.

 

  • Purpose: To evaluate the efficacy and safety of intravitreal ranibizumab vs panretinal photocoagulation for PDR.
  • Type: Randomized controlled Trial
  • Condition: Proliferative diabetic retinopathy

Participants: Proliferative diabetic retinopathy, no prior PRP, BCVA 20/320 or better, with or without centre-involving DME.

 

  • n=184 completed 5-year follow up (305 enrolled initially)

 

Intervention:

 

Group 1: Intravitreal ranibizumab 0.5mg at baseline then monthly until week 24, then PRN according to retreatment criteriae
Group 2: Panretinal photocoagulation at baseline then PRN

Both groups also received ranibizumab injections for DME at baseline

Outcome RAN PRP
Number of injections 19.2 5.4
VA change +3.1 +3.0
Visual field score change -330 -527
Vision-impairing diabetic macular oedema 22% 38%

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