Surgery and drugs are equally effective for treating diabetic eye disease

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In a new study, researchers found that surgical and injectable drug approaches are equally effective for the treatment of bleeding inside the eye from diabetic retinopathy.

A consequence of diabetes, diabetic retinopathy involves the growth of new, abnormal blood vessels in the light-sensing retina.

These blood vessels are prone to bleeding into the gel-like vitreous that fills the eye, causing vision loss.

The research was conducted by a team at the National Eye Institute.

Vitrectomy surgically removes the blood from inside the eye. To prevent more blood vessels from forming, vitrectomy is usually paired with laser treatment (laser photocoagulation).

This treatment often restores the central vision, but the laser treatment may reduce peripheral vision.

More recently, some studies found that anti-VEGF injections into the eye help control the disease and other diabetic eye complications.

These drug treatments decrease the growth of blood vessels in the eye and prevent rebleeds while the blood in the vitreous is being absorbed.

In the study, the team compared anti-vascular endothelial growth factor (VEGF) eye injections versus removal of blood via vitrectomy surgery and laser photocoagulation.

Among 205 participants, 100 were assigned an anti-VEGF drug, aflibercept (brand name Eylea), and 105 were assigned prompt vitrectomy and laser photocoagulation.

The researchers tracked best-corrected visual acuity over two years. At four weeks, visual acuity in the surgery group was much higher than the anti-VEGF group.

But by 24 weeks, the visual acuity in the anti-VEGF group had caught up to the surgery group. Visual acuity was similar between the two groups out to two years.

Approximately one in three participants in each group eventually received both types of treatments to help control their PDR during that time.

The findings can help guide treatment for people with bleeding in the eye from diabetic retinopathy.

The team says for people with severe bleeds or who need to improve their vision quickly, surgery results in more rapid improvement.

But for people who cannot receive surgery or prefer to avoid surgery if possible, anti-VEGF treatment still leads to equivalent visual outcomes over the long term.

One author of the study is Adam Glassman, Jaeb Center for Health Research.

The study is published in the Journal of the American Medical Association.

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