20 years of DRCR trials offer ‘fundamental contributions to clinical care’
Key takeaways:
- DRCR Retina Network trials have made numerous contributions to diabetic retinopathy and diabetic macular edema care over the past 20 years.
- Data suggest anti-VEGF is the standard of care for DME.
KOLOA, Hawaii — Data from various retinal clinical trials suggest that there is a difference in efficacy in anti-VEGF therapies for patients with lower vision, according to a speaker here.
During a presentation at Retina 2025, John W. Kitchens, MD, shared highlights from DRCR Retina Network studies across the past 20 years.
“We cannot overstate some of these fundamental contributions to clinical care,” he said.
Combination therapy for diabetic macular edema with an intravitreal dexamethasone implant and an anti-VEGF such as ranibizumab offers an enhanced drying effect on the retina, Kitchens explained.
“The way I treat in my clinic is I look at OCT, and I want to see the dryest possible OCT,” he said.
Research also indicates that topical antibiotics do not curb the risk for endophthalmitis, and anti-VEGF therapy is the standard of care for DME. Kitchens also noted that there is a large difference in cost among anti-VEGF therapies, and panretinal photocoagulation (PRP) in noninferior to anti-VEGF treatment for proliferative diabetic retinopathy (PDR).
Additionally, not all DME requires treatment.
“If you look at subclinical, non-center involved DME and follow those patients, not all of them progress to center involvement,” Kitchens said. “For patients with good visual acuity and center-involved DME, you don’t need to treat right away.”
Trials also indicate that pattern scan PRP may not be as effective as single-spot PRP for limiting progression of PDR.
“Protocol W, which treated patients with nonproliferative retinopathy with anti-VEGF therapy, showed that the treatment could reduce the chances of developing proliferative disease in DME,” he said. “The conclusion was: ‘We have treatment for these things. If they occur and PDR or DME develops, anti-VEGF and anti-VEGF with PRP laser treatment are effective, so why not wait and watch those patients then treat them when it occurs?’”
- Reference:
- Jaeb Center for Health Research. https://public.jaeb.org/drcrnet/pubs. Accessed Jan. 22, 2025.
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Kitchens J. Top pearls from the DRCR clinical trials. Presented at: Retina 2025; Jan. 18-24, 2025; Koloa, Hawaii.
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