Appropriate use of laser photocoagulation and anti-vascular endothelial growth factor drugs, to treat the diabetic retinopathy effectively_Chinese Journal of Ocular Fundus Diseases

Authors：

 Liu Xiaoling , Sun Zuhua

Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China;

Corresponding author：

Liu Xiaoling, Email: drliuxiaolin@163.com

Keywords：

Diabetic retinopathy/therapy; Laser coagulation; Angiogenesis inhibitors/ therapeutic use; Benchmarking; Editorial

DOI：

10.3760/cma.j.cn511434-20201013-00490

Video：

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Diabetic retinopathy (DR) is a major and irreversible blinding eye disease in working aged adults. Diabetic macular edema (DME) is a complication of the further development of DR, and it is one of the main causes of vision loss in DR patients. The emergence of anti-VEGF drugs has changed the treatment model of DR and DME. Firstly, for the treatment of DME, the previous focal/grid-like laser photocoagulation is converted to anti-VEGF drugs as the first-line treatment. Secondly, for the treatment of proliferative DR (PDR), panretinal photocoagulation (PRP) was the gold standard in the past, and now anti-VEGF drugs have become an alternative treatment for some PDR patients. In varying degrees of DR and DME, the option of treatment, anti-VEGF drug therapy replacing PRP, and the era of anti-VEGF drug therapy on DR treatment modes are worthy questions for consideration by clinicians. In-depth study of the clinical study of PRP and anti-VEGF drugs in the treatment of DR, the changes attention in clinical guidelines and expert consensus, the gradual establishment of treatment of DR and DME suitable, and the personalized treatment of DR patients may help improve the level of DR treatment in China.

Citation： Liu Xiaoling, Sun Zuhua. Appropriate use of laser photocoagulation and anti-vascular endothelial growth factor drugs, to treat the diabetic retinopathy effectively. Chinese Journal of Ocular Fundus Diseases, 2020, 36(10): 749-753. doi: 10.3760/cma.j.cn511434-20201013-00490 Copy

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2.	Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings[J]. Ophthalmology, 1978, 85(1): 82-106. DOI: 10.1016/s0161-6420(78)35693-1.
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12.	Quan Dong, Nguyen MD. 24-month evaluation of fluocinolone acetonide intravitreal insert treatment for non-infectious posterior uveitis[C]. American Academy of Ophthalmology Retina Subspecialty Day, Chicago, 2018.
13.	Sun JK, Glassman AR, Beaulieu WT, et al. Rationale and application of the Protocol S anti-vascular endothelial growth factor algorithm for proliferative diabetic retinopathy[J]. Ophthalmology, 2019, 126(1): 87-95. DOI: 10.1016/j.ophtha.2018.08.001.
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19.	Ogura Y, Shiraga F, Terasaki H, et al. Clinical practice pattern in management of diabetic macular edema in Japan: survey results of Japanese retinal specialists[J]. Jpn J Ophthalmol, 2017, 61(1): 43-50. DOI: 10.1007/s10384-016-0481-x.
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21.	Diabetic Retinopathy Clinical Research Network, Elman MJ, Qin H, et al. Intravitreal ranibizumab for diabetic macular edema with prompt versus deferred laser treatment: three-year randomized trial results[J]. Ophthalmology, 2012, 119(11): 2312-2318. DOI: 10.1016/j.ophtha.2012.08.022.
22.	Rishi P, Rishi E, Attiku Y, et al. Real-world experience with pro re nata dosing of intravitreal dexamethasone implant for eyes with refractory diabetic macular edema[J/OL]. GMS Ophthalmol Cases, 2020, 2020(10):21 [2020-04-08]. http://europepmc.org/article/MED/32676266. DOI: 10.3205/oc000148. eCollection 2020.
23.	Choi MY, Jee D, Kwon JW. Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant[J/OL]. PLoS One, 2019, 14(9): 0222364[2019-09-12]. http://europepmc.org/article/MED/31513661. DOI: 10.1371/journal.pone.0222364.
24.	Berrocal MH, Acaba LA, Acaba A. Surgery for diabetic eye complications[J]. Curr Diab Rep, 2016, 16(10): 99. DOI: 10.1007/s11892-016-0787-6.

1. Diabetic Retinopathy Study Research Group. Preliminary report on effects of photocoagulation therapy[J]. Am J Ophthalmol, 2018, 185: 14-24. DOI: 10.1016/j.ajo.2017.11.010.
2. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings[J]. Ophthalmology, 1978, 85(1): 82-106. DOI: 10.1016/s0161-6420(78)35693-1.
3. Early Treatment Diabetic Retinopathy Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 2[J]. Ophthalmology, 1987, 94(7): 761-774. DOI: 10.1016/s0161-6420(87)33527-4.
4. Early Treatment Diabetic Retinopathy Group. Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie house classification: ETDRS report number 10[J]. Ophthalmology, 1991, 98(5): 786-806. DOI: 10.1016/S0161-6420(13)38012-9.
5. Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration[J]. N Engl J Med, 2006, 355(14): 1419-1431. DOI: 10.1056/NEJMoa054481.
6. Brown DM, Kaiser PK, Michels M, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration[J]. N Engl J Med, 2006, 355(14): 1432-1444. DOI: 10.1056/NEJMoa062655.
7. Haritoglou C, Kook D, Neubauer A, et al. Intravitreal bevacizumab (Avastin) therapy for persistent diffuse diabetic macular edema[J]. Retina, 2006, 26(9): 999-1005. DOI: 10.1097/01.iae.0000247165.38655.bf.
8. Diabetic Retinopathy Clinical Research Network, Scott IU, Edwards AR. A phase Ⅱ randomized clinical trial of intravitreal bevacizumab for diabetic macular edema[J]. Ophthalmology, 2007, 114(10): 1860-1867. DOI: 10.1016/j.ophtha.2007.05.062.
9. 中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南[J]. 中华眼科杂志, 2014, 50(11): 851-865. DOI: 10.3760/cam.j.issn.0412-4081.2014.11.014.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Clinical practice guidelines of diabetic retinopathy in China (2014)[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cam.j.issn.0412-4081.2014.11.014.
10. Schmidt-Erfurth U, Garcia-Arumi J, Bandello F, et al. Guidelines for the management of diabetic macular edema by the European Society of Retina Specialists (EURETINA)[J]. Ophthalmologica, 2017, 237(4): 185-222. DOI: 10.1159/000458539.
11. Wong TY, Sun J, Kawasaki R, et al. Guidelines on diabetic eye care: the international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings[J]. Ophthalmology, 2018, 125(10): 1608-1622. DOI: 10.1016/j.ophtha.2018.04.007.
12. Quan Dong, Nguyen MD. 24-month evaluation of fluocinolone acetonide intravitreal insert treatment for non-infectious posterior uveitis[C]. American Academy of Ophthalmology Retina Subspecialty Day, Chicago, 2018.
13. Sun JK, Glassman AR, Beaulieu WT, et al. Rationale and application of the Protocol S anti-vascular endothelial growth factor algorithm for proliferative diabetic retinopathy[J]. Ophthalmology, 2019, 126(1): 87-95. DOI: 10.1016/j.ophtha.2018.08.001.
14. Virgili G, Parravano M, Evans JR, et al. Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis[J/OL]. Cochrane Database Syst Rev, 2017, 6(6): CD007419[2017-06-22]. http://europepmc.org/article/MED/28639415. DOI: 10.1002/14651858.CD007419.pub5.
15. Avery RL, Pearlman J, Pieramici DJ, et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy[J]. Ophthalmology, 2006, 113(10): 1695-1705. DOI: 10.1016/j.ophtha.2006.05.064.
16. Writing Committee for the Diabetic Retinopathy Clinical Research Network, Gross JG, Glassman AR, et al. Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial[J]. JAMA, 2015, 314(20): 2137-2146. DOI: 10.1001/jama.2015.15217.
17. Khaliq A, Foreman D, Ahmed A, et al. Increased expression of placenta growth factor in proliferative diabetic retinopathy[J]. Lab Invest, 1998, 78(1): 109-116.
18. Obeid A, Su D, Patel SN, et al. Outcomes of eyes lost to follow-up with proliferative diabetic retinopathy that received panretinal photocoagulation versus intravitreal antievascular endothelial growth factor[J]. Ophthalmology, 2019, 126(3): 407-413. DOI: 10.1016/j.ophtha.2018.07.027.
19. Ogura Y, Shiraga F, Terasaki H, et al. Clinical practice pattern in management of diabetic macular edema in Japan: survey results of Japanese retinal specialists[J]. Jpn J Ophthalmol, 2017, 61(1): 43-50. DOI: 10.1007/s10384-016-0481-x.
20. lman MJ, Bressler NM, Qin H, et al. Expanded 2-year follow-up of ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema[J]. Ophthalmology, 2011, 118(4): 609-614. DOI: 10.1016/j.ophtha.2010.12.033.
21. Diabetic Retinopathy Clinical Research Network, Elman MJ, Qin H, et al. Intravitreal ranibizumab for diabetic macular edema with prompt versus deferred laser treatment: three-year randomized trial results[J]. Ophthalmology, 2012, 119(11): 2312-2318. DOI: 10.1016/j.ophtha.2012.08.022.
22. Rishi P, Rishi E, Attiku Y, et al. Real-world experience with pro re nata dosing of intravitreal dexamethasone implant for eyes with refractory diabetic macular edema[J/OL]. GMS Ophthalmol Cases, 2020, 2020(10):21 [2020-04-08]. http://europepmc.org/article/MED/32676266. DOI: 10.3205/oc000148. eCollection 2020.
23. Choi MY, Jee D, Kwon JW. Characteristics of diabetic macular edema patients refractory to anti-VEGF treatments and a dexamethasone implant[J/OL]. PLoS One, 2019, 14(9): 0222364[2019-09-12]. http://europepmc.org/article/MED/31513661. DOI: 10.1371/journal.pone.0222364.
24. Berrocal MH, Acaba LA, Acaba A. Surgery for diabetic eye complications[J]. Curr Diab Rep, 2016, 16(10): 99. DOI: 10.1007/s11892-016-0787-6.

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Appropriate use of laser photocoagulation and anti-vascular endothelial growth factor drugs, to treat the diabetic retinopathy effectively

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