Trial reportJAMA ophthalmology2013
Exploratory analysis of the effect of intravitreal ranibizumab or triamcinolone on worsening of diabetic retinopathy in a randomized clinical trial.
Trial report in JAMA ophthalmology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Intravitreal Ranibizumab or Triamcinolone Acetonide in Combination With Laser Photocoagulation for Diabetic Macular Edema
Intravitreal Ranibizumab or Triamcinolone Acetonide as Adjunctive Treatment to Panretinal Photocoagulation for Proliferative Diabetic Retinopathy
Comparison of Surgery Outcome Between Preoperative and Intraoperative Intravitreal Injection of Ranibizumab for Vitrectomy in Proliferative Diabetic Retinopathy Patients
Efficacy and Safety Comparison of Ranibizumab and Conbercept Pretreatment Before Vitrectomy in Proliferative Diabetic Retinopathy
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 111 citations in OpenAlex.
- Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.The Cochrane database of systematic reviews · 2023Pooled it
- Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.The Cochrane database of systematic reviews · 2018Pooled it
- Anti-vascular endothelial growth factor for diabetic macular oedema: a network meta-analysis.The Cochrane database of systematic reviews · 2017Pooled it
- Combined phacoemulsification surgery and intravitreal triamcinolone injection versus stand-alone surgery in patients with type 2 diabetes: a prospective randomized trial.BMC ophthalmology · 2022Trial
- Rationale and Application of the Protocol S Anti-Vascular Endothelial Growth Factor Algorithm for Proliferative Diabetic Retinopathy.Ophthalmology · 2019Trial
- Panretinal Photocoagulation Versus Ranibizumab for Proliferative Diabetic Retinopathy: Factors Associated with Vision and Edema Outcomes.Ophthalmology · 2018Trial
- Cost Evaluation of Early Vitrectomy versus Panretinal Photocoagulation and Intravitreal Ranibizumab for Proliferative Diabetic Retinopathy.Ophthalmology · 2018Trial
- Change in Diabetic Retinopathy Through 2 Years: Secondary Analysis of a Randomized Clinical Trial Comparing Aflibercept, Bevacizumab, and Ranibizumab.JAMA ophthalmology · 2017Trial
- Anti-Vascular Endothelial Growth Factor Comparative Effectiveness Trial for Diabetic Macular Edema: Additional Efficacy Post Hoc Analyses of a Randomized Clinical Trial.JAMA ophthalmology · 2016Trial
- Posterior Vitreous Detachment Determines the Clinical Impact of Fibrovascular Membrane Fibrosis After Anti-VEGF Treatment in Proliferative Diabetic Retinopathy: A Real-World Study.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- cGAMP promotes inner blood-retinal barrier breakdown through P2RX7-mediated transportation into microglia.Journal of neuroinflammation · 2025Article
- Efficacy of Intravitreal Conbercept in Vitrectomy for Proliferative Diabetic Retinopathy: An Integrated Meta-Analysis and Bibliometric Study.Clinical ophthalmology (Auckland, N.Z.) · 2025Review
- Doxycycline inhibits MMP-2 retinal activity and modulates the angiogenic processFrontiers in cell and developmental biology · 2025Article
- Requirement of Site-Specific Tyrosine Phosphorylation of Cortactin in Retinal Neovascularization and Vascular Leakage.Arteriosclerosis, thrombosis, and vascular biology · 2024Article
- Müller cells and retinal angiogenesis: critical regulators in health and disease.Frontiers in cellular neuroscience · 2024Review
- Perspectives of diabetic retinopathy-challenges and opportunities.Eye (London, England) · 2023Review
- Targeting hypoxia-inducible factors with 32-134D safely and effectively treats diabetic eye disease in mice.The Journal of clinical investigation · 2023Article
- Network meta-analysis of intravitreal conbercept as an adjuvant to vitrectomy for proliferative diabetic retinopathy.Frontiers in endocrinology · 2023Review
- Clinical study of Chinese medicine holographic scraping combined with hot ironing in improving early diabetic retinopathy.American journal of translational research · 2023Article
- Comparison of efficacy and safety of intravitreal ranibizumab and conbercept before vitrectomy in Chinese proliferative diabetic retinopathy patients: a prospective randomized controlled trial.Eye and vision (London, England) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
importanceThe standard care for proliferative diabetic retinopathy (PDR) usually is panretinal photocoagulation, an inherently destructive treatment that can cause iatrogenic vision loss. Therefore, evaluating the effects of therapies for diabetic macular edema on development or worsening of PDR might lead to new therapies for PDR.
objectiveTo evaluate the effects of intravitreal ranibizumab or triamcinolone acetonide, administered to treat diabetic macular edema, on worsening of diabetic retinopathy.
designExploratory analysis was performed on worsening of retinopathy, defined as 1 or more of the following: (1) worsening from no PDR to PDR, (2) worsening of 2 or more severity levels on reading center assessment of fundus photographs in eyes without PDR at baseline, (3) having panretinal photocoagulation, (4) experiencing vitreous hemorrhage, or (5) undergoing vitrectomy for the treatment of PDR.
settingCommunity- and university-based ophthalmology practices.
participantsIndividuals with central-involved diabetic macular edema causing visual acuity impairment.
interventionsEyes were assigned randomly to sham with prompt focal/grid laser, 0.5 mg of intravitreal ranibizumab with prompt or deferred (≥24 weeks) laser, or 4 mg of intravitreal triamcinolone acetonide with prompt laser. MAIN OUTCOMES AND MEASURES: Three-year cumulative probabilities for retinopathy worsening.
resultsFor eyes without PDR at baseline, the 3-year cumulative probabilities for retinopathy worsening (P value comparison with sham with prompt laser) were 23% using sham with prompt laser, 18% with ranibizumab with prompt laser (P = .25), 7% with ranibizumab with deferred laser (P = .001), and 37% with triamcinolone with prompt laser (P = .10). For eyes with PDR at baseline, the 3-year cumulative probabilities for retinopathy worsening were 40%, 21% (P = .05), 18% (P = .02), and 12% (P < .001), respectively. CONCLUSIONS AND RELEVANCE Intravitreal ranibizumab appears to be associated with a reduced risk of diabetic retinopathy worsening in eyes with or without PDR. Intravitreal triamcinolone also appears to be associated with a reduced risk of PDR worsening. These findings suggest that use of these drugs to prevent worsening of diabetic retinopathy may be feasible. Given the exploratory nature of these analyses, the risk of endophthalmitis following intravitreal injections, and the fact that intravitreal triamcinolone can cause cataract or glaucoma, use of these treatments to reduce the rates of worsening of retinopathy, with or without PDR, does not seem warranted at this time.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.