Issue: February 2016
February 10, 2016
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Anti-VEGF with targeted retinal photocoagulation does not reduce treatment burden for DME patients

Issue: February 2016
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MIAMI — Anti-VEGF injections in combination with targeted retinal photocoagulation did not show a decrease in treatment burden in patients with diabetic macular edema in the DAVE trial, according to a presenter here.

“While targeted laser did not seem to hinder either the anatomic or visual acuity results, to date, we have no evidence that [suggests] targeted retinal photocoagulation reduces treatment for diabetic macular edema,” David M. Brown, MD, FACS, said at Angiogenesis, Exudation, and Degeneration 2016.

The DAVE trial included 40 patients who were randomized to receive treatment with Lucentis (ranibizumab, Genentech) alone or with ranibizumab in combination with targeted retinal photocoagulation. All patients received four injections of ranibizumab.

“The treatment arm received laser at day 7 and then repeat laser at month 6 on areas of widefield guidance,” Brown said.

Mean central thickness was 579 µm at baseline and 305 µm at 24 months in the monotherapy arm compared with 496 µm at baseline and 341 µm at 24 months in the treatment arm.

In the monotherapy arm, 45% of patients had a gain of 10 letters on the ETDRS chart compared with 35% of patients in the treatment arm.

There was no significant difference in mean visual acuity between the monotherapy arm and the treatment arm, Brown said.

“A negative study can be as important as a positive study. If you really think about it, you learn something from them,” he said. – by Kristie L. Kahl and Nhu Te

Disclosure: Brown reports he has financial interests with Genentech/Roche, Regeneron/Bayer, Alcon/Novartis, Allergan, Avalanche, Carl Zeiss Meditec, Heidelberg Engineering and Optos.