The DRCR Protocol S compared intravitreal ranibizumab with panretinal photocoagulation for the treatment of proliferative diabetic retinopathy. The principal conclusion at 2 years was:

• A Ranibizumab produced worse visual acuity outcomes than panretinal photocoagulation
• B Panretinal photocoagulation completely eliminated the need for vitrectomy whereas ranibizumab did not
• C Ranibizumab was noninferior to panretinal photocoagulation for visual acuity, with less peripheral visual field loss ✓
• D Combination therapy was required for any regression of neovascularization

Explanation

In Protocol S, eyes treated with ranibizumab achieved mean visual acuity gains that were noninferior to those treated with panretinal photocoagulation, along with less loss of peripheral visual field, fewer vitrectomies, and slightly less development of center-involved macular edema. However, ranibizumab requires frequent injections and close follow-up, and missed visits carry a risk of severe vision loss, so photocoagulation remains standard where compliance is uncertain.

Reference: American Academy of Ophthalmology Basic and Clinical Science Course, Section 12, Retina/Vitreous, recent edition ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.