Early anti-VEGF treatment of diabetic retinopathy yields no benefit to visual acuity
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. The study was funded by the National Eye Institute (NEI), part of the National Institutes of Health.
NEI-funded researchers evaluated whether treating people with NPDR with the anti-VEGF drug Eylea (aflibercept) could prevent vision loss. 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). 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. Preventative treatment continued every four months through four years unless NPDR improved to only mild disease. Sham injections (without drug) were used in 199 eyes over the same period. Any eye that developed a vision-threatening complication, such as macular edema or PDR was treated with additional anti-VEGF injections as necessary.
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. 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.
Over the four-year study, 34% percent of eyes receiving preventive treatments showed disease progression, compared with 57% of those in the sham group. On average, those in the preventive group received 11 injections, compared with an average of three in the sham group.
