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Panretinal Photocoagulation Versus Ranibizumab for Proliferative Diabetic Retinopathy: Patient-Centered Outcomes From a Randomized Clinical Trial
- Source :
- American Journal of Ophthalmology. 170:206-213
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Purpose To compare patient-centered outcomes in patients with proliferative diabetic retinopathy (PDR) treated with ranibizumab vs panretinal photocoagulation (PRP). Design Randomized clinical trial. Methods Setting: Multicenter (55 U.S. sites). Patient Population: Total of 216 adults with 1 study eye out of 305 adults (excluding participants with 2 study eyes, because each eye received a different treatment) with PDR, visual acuity 20/320 or better, no history of PRP. Intervention: Ranibizumab (0.5 mg/0.05 mL) vs PRP. Main Outcome Measures: Change from baseline to 2 years in composite and prespecified subscale scores from the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25), University of Alabama Low Luminance Questionnaire (UAB-LLQ), and Work Productivity and Activity Impairment Questionnaire (WPAIQ). Results For the NEI VFQ-25 and UAB-LLQ composite scores, ranibizumab–PRP treatment group differences (95% CI) were +4.0 (-0.2, +8.3, P = .06) and +1.8 (-3.5, +7.1, P = 0.51) at 1 year, and +2.9 (-1.5, +7.2, P = .20) and +2.3 (-2.9, +7.5, P = .37) at 2 years, respectively. Work productivity loss measured with the WPAIQ was 15.6% less with ranibizumab (-26.3%, −4.8%, P = .005) at 1 year and 2.9% (-12.2%, +6.4%, P = .54) at 2 years. Eighty-three ranibizumab participants (97%) were 20/40 or better in at least 1 eye (visual acuity requirement to qualify for an unrestricted driver's license in many states) at 2 years compared with 82 PRP participants (87%, adjusted risk ratio = 1.1, 95% CI: 1.0, 1.2, P = .005). Conclusions Though differences in some work productivity and driving-related outcomes favored ranibizumab over PRP, no differences between treatment regimens for PDR were identified for most of the other patient-centered outcomes considered.
- Subjects :
- Male
Vascular Endothelial Growth Factor A
Automobile Driving
medicine.medical_specialty
Visual acuity
genetic structures
Visual Acuity
Angiogenesis Inhibitors
Retinal Neovascularization
Panretinal photocoagulation
Article
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Ranibizumab
Sickness Impact Profile
Surveys and Questionnaires
Ophthalmology
Activities of Daily Living
Humans
Medicine
In patient
030212 general & internal medicine
Work Performance
Work productivity
Diabetic Retinopathy
Laser Coagulation
business.industry
Patient-centered outcomes
Diabetic retinopathy
Middle Aged
medicine.disease
Patient Outcome Assessment
Intravitreal Injections
030221 ophthalmology & optometry
Female
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 00029394
- Volume :
- 170
- Database :
- OpenAIRE
- Journal :
- American Journal of Ophthalmology
- Accession number :
- edsair.doi.dedup.....e05ebbfbcec0dc639b180c32850f6e91