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Prompt laser with anti-VEGF may not offer superior DME treatment
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Prompt laser treatment may not offer better outcomes than deferred laser treatment in visually impaired eyes with diabetic macular edema involving the fovea that are receiving intravitreal ranibizumab, according to a study.
The randomized clinical trial conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net) included 361 patients with diabetic macular edema involving the fovea and Snellen visual acuity of 20/32 to 20/320.
Patients were randomly assigned to undergo focal/grid laser treatment 7 to 10 days after commencement of ranibizumab therapy or delayed laser treatment at least 24 weeks after initiation of ranibizumab.
At 3 years, 144 patients who received ranibizumab plus prompt laser treatment and 147 patients who received ranibizumab plus deferred laser treatment were available for analysis.
Study results showed that patients in the deferred laser treatment group gained a mean 2.9 letters more than those in the prompt laser treatment group. The difference was statistically significant (P = .02).
Forty-two percent of eyes in the prompt laser treatment group and 56% of eyes in the deferred laser treatment group gained or lost at least 10 letters of visual acuity; the difference was statistically significant (P = .02).
Both groups had a similar incidence of systemic adverse events.
“Although these results are based on outcomes of a group, individual patients may benefit from other strategies based on individual decisions by the patient and physician,” the study authors said.
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