Photocoagulation versus ranibizumab for proliferative diabetic retinopathy: Should Baseline Characteristics Affect Choice of Treatment?

Diabetic Retinopathy Clinical Research Network

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose:Among eyes with proliferative diabetic retinopathy, identify whether baseline characteristics impact the benefit of ranibizumab over panretinal photocoagulation (PRP) in DRCR.net Protocol S.Methods:Participants had proliferative diabetic retinopathy, visual acuity of 20/320 or better, and no previous PRP. Eyes were randomized to PRP or intravitreous 0.5-mg ranibizumab.Results:Ranibizumab was superior to PRP for change in visual acuity and development of vision-impairing central-involved diabetic macular edema over 2 years (P < 0.001). Among 25 characteristics, there were none in which participants assigned to PRP had superior outcomes relative to ranibizumab-Assigned participants. The relative benefit of ranibizumab over PRP for change in visual acuity seemed greater in participants with higher mean arterial pressure (P = 0.03), without previous focal/grid laser (P = 0.03), with neovascularization of the disk and elsewhere on clinical examination (P = 0.04), and with more advanced proliferative diabetic retinopathy on photographs (P = 0.02). For development of vision-impairing central-involved diabetic macular edema, the relative benefit of ranibizumab over PRP seemed greater among nonwhite participants (P = 0.01) and those with higher mean arterial pressure (P = 0.01).Conclusion:There were no characteristics identified in which outcomes were superior with PRP compared with ranibizumab. These exploratory analyses provide additional support that ranibizumab may be a reasonable alternative to PRP for proliferative diabetic retinopathy over a 2-year period.

Original languageEnglish (US)
Pages (from-to)1646-1654
Number of pages9
JournalRetina
Volume39
Issue number9
DOIs
StatePublished - Sep 1 2019

Keywords

  • photocoagulation
  • proliferative diabetic retinopathy
  • ranibizumab

ASJC Scopus subject areas

  • Ophthalmology

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