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Laser, anti-VEGF and surgery ‘pillars’ of DR management

Healio Optometry2d ago1 min read

KIAWAH ISLAND, S.C. — Several treatments are available across the landscape of proliferative diabetic retinopathy, each with their own considerations, according to a speaker.At Kiawah Eye and Retina, David Baxley, MD, a resident at Medical University of South Carolina’s Storm Eye Institute, offered an overview of available therapies.“Panretinal photocoagulation has been the standard ever since the Diabetic Retinopathy Study showed a 60% reduction in severe vision loss. Protocol S showed us that intravitreal ranibizumab reduced the need for vitrectomy afterwards to 4% vs. 15% with PRP,” he

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AI Summary

Quick Take

At the Kiawah Eye and Retina meeting, Dr. David Baxley outlined the three pillars of proliferative diabetic retinopathy (PDR) management: panretinal photocoagulation (PRP), anti-VEGF therapy, and surgery. While PRP remains a foundational treatment for reducing severe vision loss, clinical data from Protocol S highlights the superior ability of anti-VEGF injections to reduce the subsequent need for vitrectomy.

Why It Matters

The management of PDR is evolving from a laser-first approach to a more nuanced selection between medical and surgical interventions. While PRP offers a permanent reduction in vision loss risk, the significant decrease in vitrectomy rates—from 15% with laser to just 4% with ranibizumab—makes a compelling case for anti-VEGF as a primary tool for stabilizing the retina. Clinicians must now balance these outcomes against patient-specific factors like injection burden and long-term compliance.

Key Findings

Panretinal photocoagulation (PRP) has been established as a standard of care since the Diabetic Retinopathy Study showed it reduces severe vision loss by 60%.
Data from Protocol S indicates that intravitreal ranibizumab significantly lowers the risk of requiring a vitrectomy compared to PRP (4% vs. 15%).
The current landscape of PDR management is defined by three primary therapeutic pillars: laser, anti-VEGF, and surgical intervention.

Study Snapshot

Design

Clinical trial overview (referencing DRS and Protocol S)

Population

Patients with proliferative diabetic retinopathy (PDR)

Practice Implications

When treating PDR, clinicians should consider anti-VEGF therapy not just for macular edema, but as a strategy to reduce the long-term surgical burden of vitrectomy. However, the choice between PRP and anti-VEGF must account for the 11% difference in vitrectomy risk versus the permanence of laser treatment in patients who may be lost to follow-up.

Who's Affected

Retina SpecialistsOphthalmologistsOptometrists

Evidence StrengthStrong

AI-generated summary — always read the original source for full context

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