title: A randomized controlled trial of panretinal photocoagulation with and without intravitreal ranibizumab in treatment-naive eyes with non-high-risk proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To compare the efficacy of panretinal photocoagulation (PRP) and intravitreal ranibizumab injection with PRP alone in patients with treatment-naive bilateral non-high-risk proliferative diabetic retinopathy.
  
  
  METHODS
  Sixty eyes of 30 patients were randomized either to the study group (SG) receiving PRP plus 2 ranibizumab injections or to the control group (CG) receiving PRP alone. Mean change in best-corrected visual acuity and in optical coherence tomography were compared at baseline and 1, 3, and 6 months.
  
  
  RESULTS
  Best-corrected visual acuity was significantly better at 6 months in the SG; however, there was decrease in best-corrected visual acuity in the CG. Central macula thickness decreased significantly at 6 months in SG when compared with baseline (-47.6 μm, P < 0.001) and did not reveal significant difference in the CG. In eyes with diabetic macular edema, best-corrected visual acuity increased by 3.6 letters (P = 0.06) in the SG and decreased by 4.4 letters in the CG (P = 0.003). Central macula thickness decreased by 69.3 μm (P = 0.001) in the SG and decreased by 45.5 μm (P = 0.11) in the CG.
  
  
  CONCLUSIONS
  Intravitreal ranibizumab in combination with PRP can be an effective treatment in eyes with non-high-risk proliferative diabetic retinopathy and diabetic macular edema.
authors.affiliation: *Division of Ophthalmology, University of São Paulo, São Paulo Medical School, São Paulo, Brazil; †Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska; and ‡Retinal Imaging Research and Reading Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Ferraz
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vasquez
authors.forename: Rony C
authors.initials: RC
authors.lastname: Preti
authors.forename: Augusto
authors.initials: A
authors.lastname: Motta
authors.forename: Raafay
authors.initials: R
authors.lastname: Sophie
authors.forename: Millena G
authors.initials: MG
authors.lastname: Bittencourt
authors.forename: Yasir J
authors.initials: YJ
authors.lastname: Sepah
authors.forename: Mário L R
authors.initials: ML
authors.lastname: Monteiro
authors.forename: Quan Dong
authors.initials: QD
authors.lastname: Nguyen
authors.forename: Walter Yukihiko
authors.initials: WY
authors.lastname: Takahashi
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab