Abstract
Purpose:To investigate whether anti-vascular endothelial growth factor (anti-VEGF) for diabetic macular edema or proliferative diabetic retinopathy (PDR) increases the risk of traction retinal detachment (TRD) among eyes with PDR.Methods:Pooled analysis of PDR eyes from Protocols I, J, N, S, or T with Early Treatment Diabetic Retinopathy Study level ≥61 (prompt vitrectomy was not planned) randomly assigned to the control group (laser photocoagulation, sham, or intravitreal saline; 396 eyes) or anti-VEGF (487 eyes). The primary outcome was investigator-identified TRD within 1 year of randomization.Results:The 1-year cumulative probability of TRD was 6.8% (95% confidence interval: 4.6%-9.9%, 25 events) in control-group eyes and 4.8% (95% confidence interval: 3.2%-7.3%, 22 events) in anti-VEGF group eyes (hazard ratio = 0.95 [95% confidence interval: 0.54-1.66, P = 0.86]). The cumulative probability of vitrectomy for TRD was 4.4% (16 events) in control-group eyes and 2.2% (9 events) in anti-VEGF group eyes (P = 0.19). Percentage with TRD and vitrectomy for TRD were similar within strata of diabetic retinopathy severity.Conclusion:These findings do not support the hypothesis that anti-VEGF therapy for diabetic macular edema or PDR increases the risk of TRD among eyes with PDR similar to those enrolled in five DRCR Retina Network protocols for which prompt vitrectomy was not planned.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1021-1028 |
| Number of pages | 8 |
| Journal | Retina |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2020 |
Funding
Research reported in this publication was supported by the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number EY14231, EY14229, and EY018817. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. For Protocols I, J, N, and S Genentech Inc., provided the ranibizumab and additional funds to defray clinical site costs. For Protocol T, Genentech provided ranibizumab and Regeneron provided the aflibercept. As per Industry Collaboration Guidelines (available at www.drcr.net ) the DRCR Retina Network had complete control over the design of the protocol, ownership of the data, and all editorial content of presentations and publications related to the protocols.
Keywords
- anti-vascular endothelial growth factor
- proliferative diabetic retinopathy
- traction retinal detachment
ASJC Scopus subject areas
- Ophthalmology
