Author: Karolina Szarzanowicz
Co-authors: Joseph Aslan, Fahd Quhill
Abstract
Purpose:Diabetic retinopathy (DR) is the leading cause of blindness among working age people in the UK and its prevalence is increasing. The Protocol W Randomised Clinical Trial (2021) indicated benefits of the early treatment of DR at the moderate to severe non-proliferative stage (NPDR) with aflibercept injections in preventing vision threatening complications from DR.
The aim of this study was to explore the association between panretinal photocoagulation (PRP) treatment in severe NPDR and the post-intervention prevalence of progression to proliferative DR, as well as any changes to visual acuity (VA).
Setting/ venue:
The research took place in the Royal Hallamshire Hospital, a teaching hospital in Sheffield, United Kingdom.
Methods:
A 10-year retrospective cohort study of 72 eyes with severe NDPR treated with PRP only was performed. The primary outcomes were progression to proliferative DR and change in the VA. Secondary outcomes included: identification of causes for the VA change, the need for further anti-vascular endothelial growth factor (anti-VEGF) injections, presence of complications and the final DR status.
Results:
Eleven eyes (15%) with severe NPDR progressed to proliferative DR in a mean time of 3 years. There was no significant change in VA following intervention (ETDRS= 76.3, p= 0.002). Twenty-five percent of eyes required further anti-VEGF injections (μ=2.15 injections per person) an average of 8 months after PRP.
Conclusions:
The percentage of eyes that developed proliferative DR in our retrospective study was lower (15% in 3 years) compared to the intervention group in Protocol W study (16.3% in 2 years). This suggests that PRP can be as effective as aflibercept in preventing DR progression and preserving vision in the real world while being more cost-effective and patient-friendly than serial intravitreal injections.
There are no relevant financial disclosures
