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17 Apr 2019
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Ranibizumab trumps panretinal photocoagulation for proliferative diabetic retinopathy

29 Oct 2018
Severe proliferative diabetic retinopathy Photo courtesy of Prof Tien Y Wong, Singapore National Eye Centre

Higher haemoglobin A1c level and more severe diabetic retinopathy for eyes managed with panretinal photocoagulation (PRP) are associated with less vision improvement and an increased risk of developing vision impairing central-involved diabetic macular oedema (DME), a study has shown.

On the other hand, treating proliferative diabetic retinopathy (PDR) with ranibizumab results in improved vision, with no baseline characteristics identified as associated with visual acuity or central-involved DME outcomes.

There were no factors associated with change in visual acuity or development of vision-impairing central-involved DME among eyes managed with ranibizumab after multivariable model selection with adjustment for baseline visual acuity and central subfield thickness.

For eyes managed with PRP, higher haemoglobin A1c level (–0.6 letters per 1-percent increase; 95 percent CI, –1.2 to –0.1 letters; p=0.03), more severe diabetic retinopathy (difference between high-risk PDR or worse vs moderate PDR or better, –2.8 letters; –5.5 to –0.2 letters; p=0.003) and higher mean arterial pressure (difference between ≥100 vs <100 mm Hg, –2.0 letters; –4.6 to 0.5 letters; p=0.009) were more likely to result in worse change in visual acuity.

Development of vision-impairing central-involved DME was associated with higher haemoglobin A1c level (hazard ratio [HR] per 1-percent increase, 1.31; 1.13–1.52; p<0.001), more severe diabetic retinopathy (HR for high-risk PDR or worse vs moderate PDR or better, 1.46; 0.73–2.92; p=0.03) and the presence of cystoid abnormalities within 500 μm of the macula centre (HR, 2.90; 1.35–6.24; p=0.006).

This posthoc analysis of randomized, multicentre clinical trial data included eyes completing the 2-year visit (n=328) or without vision-impairing central-involved DME at baseline (n=302) in Diabetic Retinopathy Clinical Research Network Protocol S. Eyes were treated either with intravitreous ranibizumab (0.5 mg/0.05 ml) or PRP.

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Most Read Articles
17 Apr 2019
The ketogenic and Modified Atkin’s diets are effective treatments for children with refractory epilepsy of genetic aetiology, a new study suggests.
Yesterday
A recent study has demonstrated the potential of clindamycin as a treatment alternative to antibiotic combination regardless of hidradenitis suppurativa (HS) clinical stage.
Pearl Toh, 17 Apr 2019
A contraceptive vaginal system (Annovera) releasing a combination of segesterone acetate and ethinyl estradiol (SA/EE) effectively inhibits ovulation up to a year even at low systemic levels of SA, reports a review study presented at ENDO 2019.
Roshini Claire Anthony, 2 days ago

Men with advanced prostate cancer who have pre-existing cardiovascular disease (CVD) may have an elevated mortality risk after treatment with abiraterone acetate compared with men who do not have CVD, according to a study presented at AACR 2019.