One of the most serious vision risks for people with diabetes is proliferative diabetic retinopathy (PDR), a condition in which abnormal new blood vessels rupture and bleed inside the eye. Treatments that have been shown to slow the disease include a laser procedure called panretinal photocoagulation and anti-VEGF (vascular endothelial growth factor) medication that blocks the formation of abnormal blood vessels.
To find out how these two very different approaches stack up, researchers from the Diabetic Retinopathy Clinical Research Network compared them in a randomized trial of 305 patients. The network, funded by the National Eye Institute, conducts large multicenter trials to test therapies for eye diseases. When the first results were released after the patients had been followed for two years, it looked as if the anti-VEGF drug, in this case ranibizumab (Lucentis), was more effective than panretinal photocoagulation in preserving vision.
New data from five years of follow-up found that ranibizumab’s advantage didn’t hold up over time. The mean (average) change in visual acuity from both treatments was the same after five years, and both treatments had the same rate of serious side effects. Severe vision loss or serious PDR complications were uncommon with panretinal photocoagulation or ranibizumab. The findings, which were published last year in JAMA Ophthalmology, support either ranibizumab or panretinal photocoagulation as viable PDR treatments.