title: RANIBIZUMAB PLUS PROMPT OR DEFERRED LASER FOR DIABETIC MACULAR EDEMA IN EYES WITH VITRECTOMY BEFORE ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY.
abstract: BACKGROUND
  The approach to managing diabetic macular edema in eyes with previous vitrectomy is based on limited evidence. Therefore, an exploratory post hoc assessment of 3-year data from eyes with and without vitrectomy before randomization in a DRCR.net trial that evaluated ranibizumab + prompt or deferred laser for diabetic macular edema is presented.
  
  
  METHODS
  Visual acuity and optical coherence tomography outcomes were compared between eyes with and without previous vitrectomy.
  
  
  RESULTS
  At baseline, eyes with previous vitrectomy (n = 25) had longer duration of diabetes, worse visual acuity, less thickened central subfield measurements on optical coherence tomography and were more apt to have worse diabetic retinopathy severity level or previous treatment for macular edema or cataract surgery than eyes without a history of vitrectomy (n = 335). Analyses adjusted for these baseline imbalances did not identify substantial differences between eyes with and without previous vitrectomy at each annual visit through 3 years for the favorable visual acuity, optical coherence tomography central subfield thickness, or volume outcomes, although optical coherence tomography improvement appeared slower in vitrectomy eyes during the first year.
  
  
  CONCLUSIONS
  This study provides little evidence that the beneficial clinical outcomes for patients with center-involved diabetic macular edema treated with anti-vascular endothelial growth factor are affected in the long term by previous vitrectomy.
authors.affiliation: *Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; †Jaeb Center for Health Research, Tampa, Florida; ‡Feinberg School of Medicine, Northwestern University, Chicago, Illinois; §Texas Retina Associates, Lubbock, Texas; and ¶Retina Research Center, Austin, Texas.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Bressler
authors.forename: Michele
authors.initials: M
authors.lastname: Melia
authors.forename: Adam R
authors.initials: AR
authors.lastname: Glassman
authors.forename: Talat
authors.initials: T
authors.lastname: Almukhtar
authors.forename: Lee M
authors.initials: LM
authors.lastname: Jampol
authors.forename: Michel
authors.initials: M
authors.lastname: Shami
authors.forename: Brian B
authors.initials: BB
authors.lastname: Berger
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000628:therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab