PHOTOCOAGULATION VERSUS RANIBIZUMAB FOR PROLIFERATIVE DIABETIC RETINOPATHY: Should Baseline Characteristics Affect Choice of Treatment?
| Autor: | Wesley T. Beaulieu, Adam R. Glassman, Eric Chen, Lee M. Jampol, Jeffrey G. Gross, Susan B. Bressler, Michele Melia, Michael R. Pavlica |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity genetic structures Clinical Decision-Making MEDLINE Vision Disorders Visual Acuity Angiogenesis Inhibitors Light Coagulation Affect (psychology) Panretinal photocoagulation Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Ophthalmology Ranibizumab medicine Humans 030212 general & internal medicine Aged Diabetic Retinopathy business.industry General Medicine Diabetic retinopathy Middle Aged medicine.disease eye diseases Treatment Outcome Baseline characteristics Intravitreal Injections 030221 ophthalmology & optometry Female sense organs medicine.symptom business medicine.drug |
| Zdroj: | Retina |
| ISSN: | 1539-2864 |
| Popis: | Among eyes with proliferative diabetic retinopathy, identify whether baseline characteristics impact the benefit of ranibizumab over panretinal photocoagulation (PRP) in DRCR.net Protocol S.Participants had proliferative diabetic retinopathy, visual acuity of 20/320 or better, and no previous PRP. Eyes were randomized to PRP or intravitreous 0.5-mg ranibizumab.Ranibizumab was superior to PRP for change in visual acuity and development of vision-impairing central-involved diabetic macular edema over 2 years (P0.001). Among 25 characteristics, there were none in which participants assigned to PRP had superior outcomes relative to ranibizumab-assigned participants. The relative benefit of ranibizumab over PRP for change in visual acuity seemed greater in participants with higher mean arterial pressure (P = 0.03), without previous focal/grid laser (P = 0.03), with neovascularization of the disk and elsewhere on clinical examination (P = 0.04), and with more advanced proliferative diabetic retinopathy on photographs (P = 0.02). For development of vision-impairing central-involved diabetic macular edema, the relative benefit of ranibizumab over PRP seemed greater among nonwhite participants (P = 0.01) and those with higher mean arterial pressure (P = 0.01).There were no characteristics identified in which outcomes were superior with PRP compared with ranibizumab. These exploratory analyses provide additional support that ranibizumab may be a reasonable alternative to PRP for proliferative diabetic retinopathy over a 2-year period. |
| Databáze: | OpenAIRE |
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