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Comment & Response
June 2016

Panretinal Photocoagulation vs Anti–Vascular Endothelial Growth Factor for Proliferative Diabetic Retinopathy

Author Affiliations
  • 1Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Ophthalmol. 2016;134(6):715-716. doi:10.1001/jamaophthalmol.2016.0701

To the Editor In their Viewpoint, Gross and Glassman1 have concluded that intravitreal anti–vascular endothelial growth factor (anti-VEGF) is noninferior to panretinal photocoagulation (PRP) in the treatment of proliferative diabetic retinopathy (PDR). We have a few concerns about this approach of using anti-VEGF for PDR.

In the study by the Diabetic Retinopathy Clinical Research Network2 on which this Viewpoint is based, worsening of fibrosis was included as a failure criterion in the anti-VEGF group and PRP could be performed in such eyes at investigator discretion. The investigators reported that at least 12 eyes (6%) required secondary PRP in the anti-VEGF group, for which 8 PRP treatments were done during vitrectomy. However, the baseline characteristics, causes for vitrectomy, and final outcome of these eyes have not been separately analyzed.

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