The injected drug Lucentis (ranibizumab) appears highly effective
at treating proliferative diabetic
retinopathy, a common diabetes-related eye disease, new research shows.
Investigators say the drug beat a standard treatment, laser
therapy, in curbing diabetes.
Leading cause of blindness
The findings, "provide crucial evidence for a safe and
effective alternative to laser therapy against proliferative diabetic
retinopathy", NEI Director Dr Paul Sieving said in a news release from the
U.S. National Eye Institute (NEI).
The study was funded by the NEI, which described Lucentis as the
first major advance in therapy for proliferative diabetic retinopathy in nearly
Read: 1 in 3 diabetics at risk for eye disease
The trial was conducted by the Diabetic Retinopathy Clinical
Research Network. The results were published online in the Journal
of the American Medical Association and they are also slated for
presentation at the annual meeting of the American Academy of Ophthalmology in
According to the NEI, diabetic retinopathy damages blood vessels in the light-sensitive retina in the
back of the eye, and proliferative diabetic retinopathy is an advanced form of
the disease. Nearly 8 million people in the United States have diabetic
retinopathy, making it a leading cause of blindness among working-age Americans.
Laser therapy can help preserve central vision in patients with
proliferative diabetic retinopathy, but the treatment can also damage night and
side vision, so researchers have been trying to find other therapies that are
as effective as laser but without such side effects.
The new study included 305 patients with the disease. Half were
randomly assigned to be treated with monthly injections of Lucentis (0.5
milligrams) for three months, and then on an as-needed basis until the
retinopathy resolved or at least stabilised.
Read: Keep an eye on diabetes
The other half of patients got laser treatment, the current
gold-standard therapy. About half of the patients in this group required more
than one round of treatment, the authors said.
Some patients only had treatment assessed in one eye, but others
enrolled both eyes in the study. For patients with both eyes involved in the
study, physicians used Lucentis in one eye and laser treatment on the other.
After two years, patients in the Lucentis group showed greater
improvement in the ability to read an eye chart than those in the laser group,
the researchers said. There was little change in side vision in the Lucentis
group, but a significant loss of side vision in the laser group, the study
According to study chair Dr Jeffrey Gross of the Carolina Retina
Centre in Columbia, SC, "Lucentis should be considered a viable treatment
option for people with proliferative diabetic retinopathy."
The researchers also found that Lucentis might help prevent
another condition called diabetic macular oedema, which involves a build-up of
fluid in the centre of the retina. Only 9 percent of eyes treated with Lucentis
developed macular oedema during the study, compared with 28 percent in the
laser group, the researchers said.
Read: Diabetic kids only need annual eye screenings after 5 years
Two eye experts said the study results might change the standard
of care for proliferative diabetic retinopathy.
"This has broad implications as a secondary or possibly
primary method of treatment," said Dr Mark Fromer, an ophthalmologist at
Lenox Hill Hospital in New York City. "An alternative [to laser treatment]
that can decrease negative side effects while maintaining a reduction in the
disease would be a welcome addition in the fight against proliferative diabetic
retinopathy," he said.
Dr Meenakashi Gupta is a vitreoretinal specialist and assistant
professor of ophthalmology at the New York Eye & Ear Infirmary of Mount
Sinai, also in New York City. She called the study "important", and
said that while laser therapy might still play a key role in the care of
proliferative diabetic retinopathy, Lucentis could "expand our management
strategies" for the disease.
What is diabetes?
Symptoms of diabetes