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Anti VEGF injections vs laser for retinopathy

Discussion in 'Diabetic Retinopathy' started by agwagw, Nov 28, 2017.

  1. agwagw

    agwagw LADA · Well-Known Member

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    Interesting. Though the first discussion you cite is the opinions of an individual opthamologist who favours laser and his few references are from the 70s and 80s. The second paper comes out pretty clearly that anti-VEGF is effective as long as it continues to be administered (ref comments about patients being 'lost' to follow up having worse outcomes). Some laser treatment certainly works in my experience, but the outcomes are partially dependant on the skill and dexterity of the individual opthamologist.

    My point about antiVEGF enabling improvements holds. I have lost a fair bit of night-time peripheral vision due to the laser treatment and that will never recover.

    This is the study I mentioned - though it looks at Avastin rather than Eyelea (I have read elsewhere that Eyelea is superior but I can't lay my hands on that study at the moment).

    https://journals.lww.com/retinajour...VITREAL_BEVACIZUMAB_FOR_PROLIFERATIVE.14.aspx
     
  2. Dark Horse

    Dark Horse · Well-Known Member

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    The first reference wasn't given to support PRP over anti-VEGF, only to indicate that regression of new vessels was also an aim of PRP - "The goal of PRP is to induce regression of existing neovascular tissue and to prevent progressive neovascularization." Yes, patients being lost to follow-up is a big worry with repeated injections.
     
  3. agwagw

    agwagw LADA · Well-Known Member

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    Agreed, the goal of both treatments is to try and prevent new, undesirable, blood vessel growth. If the growth is close to the fovea then laser treatment isn't possible due to the danger to central vision. Until anti-VEGF treatments were developed the only alternative was to perform a vitrectomy, which is terribly invasive.
     
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