Evaluating the effectiveness of laser photocoagulation plus anti-VEGF treatment in patients with diabetic eye disease.

This study evaluated the effectiveness of panretinal photocoagulation (PRP) plus intravitreal anti-VEGF treatment versus PRP alone for the treatment of patients with diabetic retinopathy (DR; diabetic eye disease). The data showed that PRP with anti-VEGF combination treatment improved vision without an increase in side effects compared to PRP alone in these patients.

Patients with diabetes are at risk of developing an eye disease called diabetic retinopathy (DR). Proliferative diabetic retinopathy (PDR) is the most common cause of severe visual loss in people with diabetes. In PDR blood vessels in the retina (part of the eye) become damaged, may become leaky, and increase in number. PRP has been the standard treatment for PDR. Laser photocoagulation involves treating the retina with a small laser. The laser is used to seal or destroy leaking blood vessels in the central part of the retina (macula). Due to the side effects of laser treatments (such as scarring), other therapies have been investigated.

One type of treatment for PDR is anti-VEGF drugs. They are injected into the back of the eye (intravitreal) and reduce the swelling to prevent vision loss. The anti-VEGF drugs like aflibercept (Eyelea) decrease the formation of new blood vessels in the eye and reduce the swelling. This can reduce the risk of further vision loss. However, there are few studies evaluating the effectiveness of PRP plus intravitreal anti-VEGF treatment versus PRP alone for the treatment of patients with DR.

This analysis involved 11 studies and included a total of 1182 eyes of patients with DR. Eyes of the patients were divided into 2 groups. Group 1 included 615 eyes who received PRP plus intravitreal anti-VEGF treatment combination. Group 2 included 567 eyes who received PRP alone. The average follow-up duration ranged from 1 to 12 months.

PRP plus anti-VEGF combination treatment improved the visual acuity (ability to see details) compared with PRP therapy alone by an average of 5 letters.

PRP plus anti-VEGF combination treatment reduced new vessel formation, central macula thickness, and total retinal volume compared with PRP therapy alone.

The frequency of eye side effects was similar between the groups.

This study concluded that PRP with anti-VEGF combination treatment improved vision without an increase in side effects compared to PRP alone in patients with DR.

This study analyzed different studies, most of which with very small sample sizes. The follow-up period was too short.