Among patients with proliferative diabetic retinopathy PDR), treatment with an injection in the eye of the drug ranibizumab (Lucentis) resulted in visual acuity that was not worse than panretinal photocoagulation at 2 years, according to a study appearing in an open-access article published online on November 13, 2015 in the Journal of the American Medical Association (JAMA), and intended to coincide with the study’s presentation at the American Academy of Ophthalmology 2015 Annual Meeting (November 14-17, Las Vegas, Nevada) (http://www.aao.org/annual-meeting). The JAMA article is titled “Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial.” PDR is a leading cause of vision loss in patients with diabetes mellitus, resulting in 12,000 to 24,000 new cases of blindness each year in the United States. Pan-retinal photocoagulation (PRP), a laser procedure is currently the standard treatment for reducing severe visual loss from PDR. However, PRP can cause permanent peripheral visual field loss and decreased night vision and may exacerbate diabetic macular edema (DME), which is swelling of the retina in diabetes mellitus due to leaking of fluid from blood vessels within the macula of the eye). These negative effects make alternative treatments desirable, according to background information provided in the JAMA article. When used as treatment of DME, intra-vitreous anti-vascular endothelial growth factor (anti-VEGF) agents reduce the risk of diabetic retinopathy worsening and increase the chance of improvement, making these agents a potentially viable PDR treatment. Adam R.
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