These final, four-year results reinforce the earlier finding, with no statistical difference in either visual acuity or rates of vision loss between the two groups. Two-year results of the study suggested that while preventive treatment reduced the risk of developing diabetic macular edema or PDR, there was no evident benefit to vision. Any eye that developed a vision-threatening complication, such as macular edema or PDR was treated with additional anti-VEGF injections as necessary. Sham injections (without drug) were used in 199 eyes over the same period. Preventative treatment continued every four months through four years unless NPDR improved to only mild disease. Preventive anti-VEGF injections were given in 200 eyes at one month after enrollment, two months, and four months, and then every four months over two years. The study enrolled 328 participants, with 399 study eyes (some participants had two eyes that met criteria for enrollment in the study others only had one study-eligible eye). NEI-funded researchers evaluated whether treating people with NPDR with the anti-VEGF drug Eylea (aflibercept) could prevent vision loss. Progression of the disease to proliferative diabetic retinopathy (PDR), where new, abnormal blood vessels begin to grow in the retina, can also threaten vision. Fluid buildup in the retina, called diabetic macular edema, is a complication of diabetic retinopathy and can lead to vision loss. This stage is called non-proliferative diabetic retinopathy (NPDR). In early stages, diabetes weakens retinal blood vessels, causing fluid to leak into the surrounding retina. Anti-VEGF is given by injection into the eye, so physicians must weigh the risks for side effects and the expense and inconvenience of treatment against potential treatment benefit.ĭiabetic retinopathy occurs when diabetes affects the blood vessels of the eye’s light-sensing retina. However, eye care providers have been unsure when treatment should start to achieve the best long-term outcome. The report was published today in the Journal of the American Medical Association (JAMA).Īnti-vascular endothelial growth factor (anti-VEGF) drugs can substantially decrease the risk of vision loss from diabetic retinopathy. “This study indicates that monitoring patients regularly for vision-threatening diabetes complications and treating eyes only as needed is the best approach,” said Raj Maturi, M.D., Indiana University School of Medicine and Retina Partners Midwest, who is the protocol chair for the four-year study. The study was funded by the National Eye Institute (NEI), part of the National Institutes of Health. While early treatment of diabetes-related eye disease slowed progression to severe disease, it did not improve visual acuity compared with treating more severe disease once it developed, according to a clinical study from the DRCR Retina Network. Images illustrate vision improvement with treatment for diabetic retinopathy.
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