Study Compares Lucentis vs Laser For Diabetic Retinopathy

MedicalResearch.com Interview with:
Adam R. Glassman, MS

Jaeb Center for Health Research
Tampa, FL 33647

Medical Research: What is the background for this study? What are the main findings?

Response: Diabetic retinopathy is a complication of diabetes that affects blood vessels in the retina. When diabetic retinopathy worsens to proliferative diabetic retinopathy, blood vessels in the retina can leak fluid or bleed, distorting vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and the leading cause of blindness among working-age adults.

Scatter laser treatment, also called panretinal photocoagulation, has been standard therapy for the treatment of proliferative diabetic retinopathy since the 1970s. While effective in preserving central vision, laser therapy can reduce side vision and cause swelling in an area of the retina that is important for central vision. This study aimed to find an alternative therapy that avoided these undesirable side effects.

Eyes in this study were assigned randomly to treatment with intraocular anti-VEGF injections of Lucentis® or scatter laser treatment. The results of this study demonstrate that eye injections of Lucentis® are as effective for vision outcomes at 2 years as laser therapy. On average, vision among eyes treated with Lucentis® improved by about half a line on an eye chart, with virtually no improvement among eyes treated with laser therapy. Compared with laser-treated eyes, eyes treated with Lucentis injection on average had less side vision loss, less frequent development of swelling in the central retina, and fewer complex retina surgeries for retinal bleeding or retinal detachment.

Medical Research: What should clinicians and patients take away from your report?

Response: This study should help doctors and patients make informed treatment decisions regarding the management of proliferative diabetic retinopathy. Lucentis injections may be a reasonable alternative to laser therapy through at least 2 years for patients with proliferative diabetic retinopathy, especially if the patient is also planning to receive anti-VEGF treatment for diabetic macular edema. However, treatment cost, patient adherence to follow-up and frequency of follow-up should be considered when making individual treatment decisions.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: The current study is continuing for three years for each participant to assess the longer term comparative effectiveness of these treatment strategies. It will be interesting to know if the effects of Lucentis seen through 2 years are maintained through 5 years and how many injections are needed to maintain benefit. It would also be interesting to know whether an anti-VEGF drug might be used to prevent the development of proliferative diabetic retinopathy and/or diabetic macular edema. Such a preventive approach might lead to better vision and less need for therapeutic intervention.

Citation:

Writing Committee for the Diabetic Retinopathy Clinical Research Network. Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial.JAMA. Published online November 13, 2015. doi:10.1001/jama.2015.15217.

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Adam R. Glassman, MS (2015). Study Compares Lucentis vs Laser For Diabetic Retinopathy