June 2013
Volume 54, Issue 15
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ARVO Annual Meeting Abstract  |   June 2013
Intravitreal Ranibizumab Combined with Panretinal Photocoagulation in Patients with Treatment-Naive Proliferative Diabetic Retinopathy
Daniel Ferraz; Raafay Sophie; Millena Bittencourt; Rony Preti; Lisa Vazquez; Augusto Motta; Mostafa Hanout; Yasir Sepah; Quan Dong Nguyen; Walter Takahashi
Author Affiliations & Notes
  • Daniel Ferraz
    Ophthalmology, University of São Paulo, São Paulo, Brazil
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Raafay Sophie
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Millena Bittencourt
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Rony Preti
    Ophthalmology, University of São Paulo, São Paulo, Brazil
  • Lisa Vazquez
    Ophthalmology, University of São Paulo, São Paulo, Brazil
  • Augusto Motta
    Ophthalmology, University of São Paulo, São Paulo, Brazil
  • Mostafa Hanout
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Yasir Sepah
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Quan Dong Nguyen
    Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
  • Walter Takahashi
    Ophthalmology, University of São Paulo, São Paulo, Brazil
  • Footnotes
    Commercial Relationships Daniel Ferraz, None; Raafay Sophie, None; Millena Bittencourt, None; Rony Preti, None; Lisa Vazquez, None; Augusto Motta, None; Mostafa Hanout, None; Yasir Sepah, None; Quan Dong Nguyen, Genentech (F), Regeneron (F), Lux Biosciences (F), Abbott (F), GSK (F), Santen (F), Santen (C), Bausch and Lomb (C), Optos (F), Heidelberg Engineering (F); Walter Takahashi, Novartis (C), Bayer (C), Bayer (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5761. doi:
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      Daniel Ferraz, Raafay Sophie, Millena Bittencourt, Rony Preti, Lisa Vazquez, Augusto Motta, Mostafa Hanout, Yasir Sepah, Quan Dong Nguyen, Walter Takahashi; Intravitreal Ranibizumab Combined with Panretinal Photocoagulation in Patients with Treatment-Naive Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5761.

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Abstract
 
Purpose
 

To evaluate the efficacy of combination therapy with ranibizumab (RBZ) and panretinal photocoagulation (PRP) versus PRP alone in patients with treatment-naive bilateral proliferative diabetic retinopathy (PDR) as measured by mean change in visual acuity (VA), mean change in central retinal thickness (CRT) as measured by time-domain optic coherence tomography (TD-OCT) and incidence of vitreous hemorrhage (VH).

 
Methods
 

At the baseline and follow up visits (months 1, 3 and 6), the patients underwent complete ophthalmic examination and OCT evaluation. All patients were treated with bilateral PRP administered in three sessions according to ETDRS guidelines. Intravitreal injections of RBZ were given in one randomly selected eye at weeks 1 and 4 (group 1). The fellow eye received sham treatments (group 2). The Wilcoxon Signed Rank test was applied to compare the difference in VA and CRT between baseline and Month 6.

 
Results
 

Thirty patients (n= 56 eyes) completed the study; four eyes did not have complete VA and OCT data. Baseline demographics were well balanced between the groups (Table 1). In eyes with clinically significant macular edema (CSME) and CRT greater than 250µm, VA increased by 4.1 letters in group 1 (p=0.02) and decreased by 5.0 letters in group 2 (p=0.01) at the primary endpoint (month 6). In group 1, CRT decreased by 52 um (p=0.001), whereas in group 2, there was no significant change in thickness (p=0.09). In eyes without edema (no CSME and CRT≤250 µm), VA improved by 8.3 letters at month 6 in group 1 (p=0.05), with no significant change in group 2 (ΔVA =-1.6, p=0.69). The CRT showed no significant changes in both groups: group1, ΔCRT=1.9, p= 0.58 and group 2, ΔCRT=17.1, p=0.19. The proportion of eyes with development of VH was lower in group 1 when compared to group 2 (10% vs 23%, p=0.16).

 
Conclusions
 

Intravitreal RBZ in conjunction with PRP can be an effective combination treatment in eyes with PDR and CSME.

 
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Keywords: 499 diabetic retinopathy • 578 laser • 505 edema  
© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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