Treatment with ranibizumab led to visual acuity that was not worse than panretinal photocoagulation (PRP) in a randomized trial of 305 adults with proliferative diabetic retinopathy conducted at 55 US sites.

Participants were randomly assigned to receive PRP in 1 to 3 visits (n=203 eyes), or ranibizumab, 0.5 mg, by intravitreous injection as often as every 4 weeks (n=191 eyes). All patients were able to get ranibizumab for diabetic macular edema (DME).

Among the results:

• Average visual acuity improvement at 2 years was +2.8 in those receiving ranibizumab vs +0.2 for PRP.

• The average treatment group difference in visual acuity area under the curve over 2 years was +4.2.

• Average peripheral visual field sensitivity loss was worse, vitrectomy was more frequent, and DME development was more frequent in those receiving PRP vs ranibizumab.

• Rates of major cardiovascular events were similar in both groups.

Citation: Gross J, Glassman A, Jampol L, et al. Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: A randomized clinical trial. [Published online ahead of print November 13, 2015]. JAMA. doi:10.1001/jama.2015.15217.