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Recent clinically relevant highlights from the Diabetic Retinopathy Clinical Research Network.
Curr Opin Ophthalmol. 2018 May; 29(3):199-205.CO

Abstract

PURPOSE OF REVIEW

To present some recent clinically relevant results from Diabetic Retinopathy Clinical Research (DRCR) Network trials that may guide management of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR).

RECENT FINDINGS

Among eyes with DME and visual acuity 20/50 or worse, aflibercept, on average, had greater improvement in visual acuity over 2 years compared with bevacizumab or ranibizumab. Aflibercept is associated with higher rates of improvements in diabetic retinopathy severity among eyes with PDR and vision-impairing DME at baseline compared with bevacizumab or ranibizumab. Among eyes with persistent central-involved DME after at least six antivascular endothelial growth factor (anti-VEGF) injections, no difference in mean visual acuity improvement was observed between eyes that received continued ranibizumab and sham injections versus ranibizumab and intravitreous sustained dexamethasone drug-delivery system, especially for phakic eyes. For eyes with PDR, ranibizumab was associated with lower rates of developing PDR-worsening events compared with panretinal photocoagulation, especially among eyes that did not receive ranibizumab for central-involved DME at baseline. Ranibizumab is cost-effective for PDR for eyes with, not without, vision-impairing central-involved DME, highlighting challenges when safety and efficacy results are at odds with cost-effectiveness results.

SUMMARY

Aflibercept for DME, in certain circumstances, is more likely to have superior visual acuity and anatomical outcomes compared with bevacizumab or ranibizumab. No vision benefits are apparent, especially for phakic eyes, by adding intravitreous corticosteroids for persistent DME following anti-VEGF injections.

Authors+Show Affiliations

Retina Division, Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29528861

Citation

Krick, Tracy W., and Neil M. Bressler. "Recent Clinically Relevant Highlights From the Diabetic Retinopathy Clinical Research Network." Current Opinion in Ophthalmology, vol. 29, no. 3, 2018, pp. 199-205.
Krick TW, Bressler NM. Recent clinically relevant highlights from the Diabetic Retinopathy Clinical Research Network. Curr Opin Ophthalmol. 2018;29(3):199-205.
Krick, T. W., & Bressler, N. M. (2018). Recent clinically relevant highlights from the Diabetic Retinopathy Clinical Research Network. Current Opinion in Ophthalmology, 29(3), 199-205. https://doi.org/10.1097/ICU.0000000000000472
Krick TW, Bressler NM. Recent Clinically Relevant Highlights From the Diabetic Retinopathy Clinical Research Network. Curr Opin Ophthalmol. 2018;29(3):199-205. PubMed PMID: 29528861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recent clinically relevant highlights from the Diabetic Retinopathy Clinical Research Network. AU - Krick,Tracy W, AU - Bressler,Neil M, PY - 2018/3/13/pubmed PY - 2018/4/21/medline PY - 2018/3/13/entrez SP - 199 EP - 205 JF - Current opinion in ophthalmology JO - Curr Opin Ophthalmol VL - 29 IS - 3 N2 - PURPOSE OF REVIEW: To present some recent clinically relevant results from Diabetic Retinopathy Clinical Research (DRCR) Network trials that may guide management of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). RECENT FINDINGS: Among eyes with DME and visual acuity 20/50 or worse, aflibercept, on average, had greater improvement in visual acuity over 2 years compared with bevacizumab or ranibizumab. Aflibercept is associated with higher rates of improvements in diabetic retinopathy severity among eyes with PDR and vision-impairing DME at baseline compared with bevacizumab or ranibizumab. Among eyes with persistent central-involved DME after at least six antivascular endothelial growth factor (anti-VEGF) injections, no difference in mean visual acuity improvement was observed between eyes that received continued ranibizumab and sham injections versus ranibizumab and intravitreous sustained dexamethasone drug-delivery system, especially for phakic eyes. For eyes with PDR, ranibizumab was associated with lower rates of developing PDR-worsening events compared with panretinal photocoagulation, especially among eyes that did not receive ranibizumab for central-involved DME at baseline. Ranibizumab is cost-effective for PDR for eyes with, not without, vision-impairing central-involved DME, highlighting challenges when safety and efficacy results are at odds with cost-effectiveness results. SUMMARY: Aflibercept for DME, in certain circumstances, is more likely to have superior visual acuity and anatomical outcomes compared with bevacizumab or ranibizumab. No vision benefits are apparent, especially for phakic eyes, by adding intravitreous corticosteroids for persistent DME following anti-VEGF injections. SN - 1531-7021 UR - https://www.unboundmedicine.com/medline/citation/29528861/Recent_clinically_relevant_highlights_from_the_Diabetic_Retinopathy_Clinical_Research_Network_ L2 - https://doi.org/10.1097/ICU.0000000000000472 DB - PRIME DP - Unbound Medicine ER -