Early anti-VEGF treatment of diabetic retinopathy yields no benefit to visual acuity : NIH clinical trial findings

8 Feb 2023 • Preventive treatment for diabetic retinopathy with anti-VEGF injections may not meaningfully slow vision loss, according to a new study. 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) & the report was published in the Journal of the American Medical Association (JAMA).

Researchers evaluated whether treating people with NPDR(non-proliferative diabetic retinopathy) 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. Over the four-year study, 34% percent of eyes receiving preventive treatments showed disease progression, compared with 57% of those in the sham group. 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.

“We expected early treatment to prevent progression of diabetic retinopathy, but even with preventative injections, about one-third of eyes developed vision-threatening complications,” said Adam Glassman, Jaeb Center for Health Research, Tampa, Florida, who directs the DRCR Retina Network coordinating center. Source: NIH | Read full story

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