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Long-term results support PRP or ranibizumab for proliferative diabetic retinopathy

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Jeffrey G. Gross

VANCOUVER, British Columbia — The 5-year outcomes from the DRCR.net Protocol S study support the use of either ranibizumab or panretinal photocoagulation for the treatment of proliferative diabetic retinopathy, according to a speaker here.

“These findings support either ranibizumab or PRP as viable treatment for proliferative diabetic retinopathy. Patient-specific factors should be considered,” Jeffrey G. Gross, MD, said at the American Society of Retina Specialists annual meeting.

The previously published 2-year outcomes for the study showed the mean change in visual acuity in patients treated with Lucentis (ranibizumab, Genentech) was no worse than in patients treated with PRP; PRP was favored in secondary outcomes such as fewer visits, fewer injections and cost-effectiveness when diabetic macular edema causing vision impairment was not present, Gross said.

At baseline, 394 eyes of 305 participants were randomly assigned to receive either ranibizumab (191 eyes) or PRP (203 eyes). At 5 years, 66% of participants (excluding deaths) completed the study, he said.

At 5 years, the mean change in visual acuity outcomes was similar between the two groups. Ranibizumab resulted in decreased DME and decreased retinal detachments, while PRP resulted in fewer visits and fewer injections, Gross said.

“Both groups had very good vision at the end of 5 years. Substantial vision loss was rare, and visual field loss progressed in years 2 to 5. Vitreous hemorrhage appeared in almost half in both groups,” Gross said. – by Robert Linnehan

Reference:

Gross JG. Randomized trial of panretinal photocoagulation versus ranibizumab for proliferative diabetic retinopathy: 5-year outcomes. Presented at: American Society of Retina Specialists annual meeting; July 20-25, 2018; Vancouver, British Columbia.

Disclosure: Gross reports he is an investigator for Acucela, Genentech/Roche, Jaeb Center for Health Research, Ohr Pharmaceutical and Regeneron, and is a stockholder of Covalent.