Last updated on September 2017

Anti-VEGF vs. Prompt Vitrectomy for VH From PDR


Brief description of study

Although vitreous hemorrhage (VH) from proliferative diabetic retinopathy (PDR) can cause acute and dramatic vision loss for patients with diabetes, there is no current, evidence-based clinical guidance as to what treatment method is most likely to provide the best visual outcomes once intervention is desired. Intravitreous anti-vascular endothelial growth factor (anti-VEGF) therapy alone or vitrectomy combined with intraoperative PRP each provide the opportunity to stabilize or regress retinal neovascularization. However, clinical trials are lacking to elucidate the relative time frame of visual recovery or final visual outcome in prompt vitrectomy compared with initial anti-VEGF treatment. The Diabetic Retinopathy Clinical Research Network Protocol N demonstrated short-term trends consistent with a possible beneficial effect of anti-VEGF treatment in eyes with VH from PDR, including greater visual acuity improvement and reduced rates of recurrent VH as compared with saline injection. It is possible that a study with a longer duration of follow-up with structured anti-VEGF retreatment would demonstrate even greater effectiveness of anti-VEGF for VH to avoid vitrectomy and its attendant adverse events while also improving visual acuity. On the other hand, advances in surgical techniques leading to faster operative times, quicker patient recovery, and reduced complication rates may make prompt vitrectomy a more attractive alternative since it results in the immediate ability to clear hemorrhage and to perform PRP if desired, often as part of one procedure. This proposed study will evaluate the safety and efficacy of two treatment approaches for eyes with VH from PDR: prompt vitrectomy + PRP and intravitreous aflibercept injections.

Clinical Study Identifier: NCT02858076

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Amr Dessouki, MD

Retinal Diagnostic Center
Campbell, CA United States
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Kent W. Small, MD

Macula & Retina Institute
Glendale, CA United States
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Hani Salehi-Had, MD

Atlantis Eye Care
Huntington Beach, CA United States
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Joseph T. Fan, MD

Loma Linda University Health Care, Department of Ophthalmology
Loma Linda, CA United States
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Shashi D. Ganti, MD

Shashi D Ganti, MD PC
Porterville, CA United States
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Scott M Friedman, MD

Florida Retina Consultants
Lakeland, FL United States
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Oren Z. Plous, MD

Southeast Eye Institute, P.A. dba Eye Associates of Pinellas
Pinellas Park, FL United States
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Elizabeth R. Richter, MD, PhD

Retina Associates of Sarasota
Sarasota, FL United States
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Ivan J Suner, MD

Retina Associates of Florida, P.A.
Tampa, FL United States
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Andrew M Hendrick, MD

Emory Eye Center
Atlanta, GA United States
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Dennis M Marcus, MD

Southeast Retina Center, P.C.
Augusta, GA United States
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Annal D Meleth, MD, MS

Marietta Eye Clinic
Marietta, GA United States
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Paul L Kaufman, MD

Thomas Eye Group
Sandy Springs, GA United States
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Sumit P. Bhatia, MD

Gailey Eye Clinic
Bloomington, IL United States
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Alice T. Lyon, MD

Northwestern Medical Faculty Foundation
Chicago, IL United States
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Jennifer I. Lim, MD

University of Illinois at Chicago Medical Center
Chicago, IL United States
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Leanne T. Labriola, DO

Carle Foundation Hospital
Urbana, IL United States
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Raj K. Maturi, MD

Raj K. Maturi, MD, PC
Indianapolis, IN United States
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Howard S. Lazarus, MD

John-Kenyon American Eye Institute
New Albany, IN United States
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Gregory M. Fox, MD

Retina Associates, P.A.
Shawnee, KS United States
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Carl W Baker, MD

Paducah Retinal Center
Paducah, KY United States
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Ruben A. Grigorian, MD

Eye Associates of Northeast Louisiana dba Haik Humble Eye Center
West Monroe, LA United States
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Michael J Elman, MD

Elman Retina Group, P.A.
Baltimore, MD United States
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Sharon D Solomon, MD

Wilmer Eye Institute at Johns Hopkins
Baltimore, MD United States
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Gisela Velez, MD, MPH, MA

Valley Eye Physicians and Surgeons
Ayer, MA United States
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Lloyd P Aiello, MD, PhD

Joslin Diabetes Center
Boston, MA United States
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Thomas W. Gardner, MD, MS

Kellogg Eye Center, University of Michigan
Ann Arbor, MI United States
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Paul A Edwards, MD

Henry Ford Health System, Dept of Ophthalmology and Eye Care Services
Detroit, MI United States
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Thomas M. Aaberg, Jr., MD

Retina Specialists of Michigan
Grand Rapids, MI United States
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Abdhish R. Bhavsar, MD

Retina Center, PA
Minneapolis, MN United States
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Andrew J. Barkmeier, MD

Mayo Clinic Department of Ophthalmology
Rochester, MN United States
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William N Rosenthal, MD

Mid-America Retina Consultants, P.A.
Kansas City, MO United States
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Kevin J Blinder, MD

The Retina Institute
Saint Louis, MO United States
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Ronald C Gentile, MD

The New York Eye and Ear Infirmary/Faculty Eye Practice
New York, NY United States
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Daniel F. Rosberger, MD, PhD, ...

MaculaCare
New York, NY United States
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Szilard Kiss, MD

Weill Cornell Medical College
New York, NY United States
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George R Hampton, MD

Retina-Vitreous Surgeons of Central New York, PC
Syracuse, NY United States
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Seema Garg, MD, PhD

Kittner Eye Center
Chapel Hill, NC United States
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David Browning, MD

Charlotte Eye, Ear, Nose and Throat Assoc., PA
Charlotte, NC United States
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Lawrence J. Singerman, MD

Retina Associates of Cleveland, Inc.
Beachwood, OH United States
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Yu H Kim, MD

University Hospitals Cleveland Medical Center
Cleveland, OH United States
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Sandeep N. Shah, MD

Retina Vitreous Center
Edmond, OK United States
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Ronald M Kingsley, MD

Dean A. McGee Eye Institute
Oklahoma City, OK United States
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Albert O. Edwards, MD, PhD

Oregon Retina, LLP
Eugene, OR United States
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Mark A. Peters, MD, FACS

Retina Northwest, PC
Portland, OR United States
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Andreas K. Lauer, MD

Casey Eye Institute
Portland, OR United States
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Karl R. Olsen, MD

Retina Vitreous Consultants
Monroeville, PA United States
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John A. Wells, III, MD, ...

Palmetto Retina Center
West Columbia, SC United States
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Richard I Breazeale, MD

Southeastern Retina Associates
Chattanooga, TN United States
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Joseph M Googe, MD

Southeastern Retina Associates, P.C.
Knoxville, TN United States
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J. E. Ysasaga, MD

Southwest Retina Specialists
Amarillo, TX United States
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Brian B. Berger, MD

Retina Research Center
Austin, TX United States
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Joseph A. Khawly, MD

Retina and Vitreous of Texas
Houston, TX United States
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Christina Y. Weng, MD, MBA

Baylor Eye Physicians and Surgeons
Houston, TX United States
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Michel Shami, MD

Texas Retina Associates
Lubbock, TX United States
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Victor H. Gonzalez, MD

Valley Retina Institute
McAllen, TX United States
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Michael A. Singer, MD

Medical Center Ophthalmology Associates
San Antonio, TX United States
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Calvin E Mein, MD

Retinal Consultants of San Antonio
San Antonio, TX United States
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Robert S. Wirthlin, MD

Spokane Eye Clinic
Spokane, WA United States
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Judy E. Kim, MD

Medical College of Wisconsin
Milwaukee, WI United States
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Eduardo V. Navajas, MD,PhD,FRCSC

UBC/VCHA Eye Care Centre
Vancouver, BC Canada
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Michael H. Brent, MD, FRCSC

University Health Network - Toronto Western Hospital
Toronto, ON Canada
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