Last updated on March 2019

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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Retinal Diagnostic Center

Campbell, CA United States

Macula & Retina Institute

Glendale, CA United States

Atlantis Eye Care

Huntington Beach, CA United States

Shashi D Ganti, MD PC

Porterville, CA United States

Florida Retina Consultants

Lakeland, FL United States

Retina Associates of Sarasota

Sarasota, FL United States

Retina Associates of Florida, P.A.

Tampa, FL United States

Emory Eye Center

Atlanta, GA United States

Southeast Retina Center, P.C.

Augusta, GA United States

Marietta Eye Clinic

Marietta, GA United States

Thomas Eye Group

Sandy Springs, GA United States

Gailey Eye Clinic

Bloomington, IL United States

Northwestern Medical Faculty Foundation

Chicago, IL United States

Carle Foundation Hospital

Urbana, IL United States

Raj K. Maturi, MD, PC

Indianapolis, IN United States

John-Kenyon American Eye Institute

New Albany, IN United States

Retina Associates, P.A.

Shawnee, KS United States

Paducah Retinal Center

Paducah, KY United States

Elman Retina Group, P.A.

Baltimore, MD United States

Wilmer Eye Institute at Johns Hopkins

Baltimore, MD United States

Valley Eye Physicians and Surgeons

Ayer, MA United States

Joslin Diabetes Center

Boston, MA United States

Kellogg Eye Center, University of Michigan

Ann Arbor, MI United States

Retina Specialists of Michigan

Grand Rapids, MI United States

Retina Center, PA

Minneapolis, MN United States

Mayo Clinic Department of Ophthalmology

Rochester, MN United States

Mid-America Retina Consultants, P.A.

Kansas City, MO United States

The Retina Institute

Saint Louis, MO United States


New York, NY United States

Weill Cornell Medical College

New York, NY United States

Kittner Eye Center

Chapel Hill, NC United States

Retina Associates of Cleveland, Inc.

Beachwood, OH United States

University Hospitals Cleveland Medical Center

Cleveland, OH United States

Retina Vitreous Center

Edmond, OK United States

Dean A. McGee Eye Institute

Oklahoma City, OK United States

Oregon Retina, LLP

Eugene, OR United States

Retina Northwest, PC

Portland, OR United States

Casey Eye Institute

Portland, OR United States

Retina Vitreous Consultants

Monroeville, PA United States

Palmetto Retina Center

West Columbia, SC United States

Southeastern Retina Associates

Chattanooga, TN United States

Southeastern Retina Associates, P.C.

Knoxville, TN United States

Southwest Retina Specialists

Amarillo, TX United States

Retina Research Center

Austin, TX United States

Retina and Vitreous of Texas

Houston, TX United States

Baylor Eye Physicians and Surgeons

Houston, TX United States

Texas Retina Associates

Lubbock, TX United States

Valley Retina Institute

McAllen, TX United States

Medical Center Ophthalmology Associates

San Antonio, TX United States

Retinal Consultants of San Antonio

San Antonio, TX United States

Spokane Eye Clinic

Spokane, WA United States

Medical College of Wisconsin

Milwaukee, WI United States

UBC/VCHA Eye Care Centre

Vancouver, BC Canada

Recruitment Status: Closed

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