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  • Ranibizumab vs. PRP for Proliferative Diabetic Retinopathy


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    Treatment for proliferative diabetic retinopathy (PDR) is undergoing a sea change: According to a report from the Diabetic Retinopathy Clinical Research Network (DRCR.net), treatment of PDR with ranibizumab proved to be noninferior to panretinal photocoagulation (PRP) at the 2-year mark.

    In announcing the results of the study, Jeffrey G. Gross, MD, described them as the “first major advance in the treatment of PDR in 40 years.” His presentation, which took place at Retina Subspecialty Day on Friday, coincided with the study’s publication in the Journal of the American Medical Association.1

    Study participants were at least 18 years old, had PDR in at least 1 eye, and had not previously undergone PRP. All told, 191 eyes were randomized to receive ranibizumab, and 203 were treated with PRP. At 2 years, results were available for 160 eyes in the ranibizumab group and 168 in the PRP cohort.

    The primary outcome was the mean change in visual acuity (VA) from baseline to 2 years. At 2 years, those in the ranibizumab group had gained 2.8 letters, while those treated with PRP had gained 0.2 letters.

    In addition to treating PDR, the study suggests that ranibizumab may help with diabetic macular edema (DME): Only 9% of those in the ranibizumab group developed DME, compared with 28% of those in the PRP group.

    Patients in the study will continue to be followed for a total of 5 years.—Jean Shaw

    Financial disclosures. Dr. Gross—Acucela; S; Jaeb Center for Health Research: S.

    Disclosure key.     C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.

    1Writing Committee for the Diabetic Retinopathy Clinical Research Network. JAMA. Published online Nov. 13, 2015. doi:10.1001/jama.2015.15317.