Carl Baker: Panretinal Photocoagulation vs. Ranibizumab for Diabetic Retinopathy Treatment

Carl Baker, MD: The biggest implications are the diabetic retinopathy clinical research network, in their study on protocol S, showed that anti-VEGF injections, particularly ranibizumab, were a viable alternative to pan retinal photocoagulation for the management of PDR (proliferative diabetic retinopathy). In that study, over a course of 2 years, and generally speaking throughout the course of this study visual acuities were a little better in eyes that were treated with anti-VEGF agents and by the end of 2 years the visual acuities remained stable enough to say that there was no inferiority and treating those patients with Lucentis.

Throughout the course of this study, we did find that patients who were treated with injections versus laser had fewer vitrectomies and fewer instance of retinal detachments and vitreous hemorrhages. We wanted to look at what were the factors that were associated with that, so we did an analysis of the data and we found that in eyes that had more severe retinopathy, whether they were treated with laser or with injections, they were at a higher risk of developing the complications of peripheral diabetic retinopathy including bitterest images retinal detachments and the need for vitrectomy surgery.

When we compared those groups throughout the course of this study, the risk factors were similar between the 2, although the eyes that got laser had actually a little better baseline diabetic retinopathy severity. So when we ingested for the retinopathy severity for those eyes, we found that the differences between the two groups were even more significant, which means that the eyes that received injections had a more significantly reduced rate of diabetic retinopathy complications.