Clinical Studies:

DRCR Protocol AB

Summarized by Kyle Kovacs, MD (Weill Cornell Medicine Department of Ophthalmology)


Antoszyk AN, Glassman AR, Beaulieu WT, Jampol LM, Jhaveri CD, Punjabi OS, Salehi-Had H, Wells JA 3rd, Maguire MG, Stockdale CR, Martin DF, Sun JK; DRCR Retina Network. Effect of Intravitreous Aflibercept vs Vitrectomy With Panretinal Photocoagulation on Visual Acuity in Patients With Vitreous Hemorrhage From Proliferative Diabetic Retinopathy: A Randomized Clinical Trial. JAMA. 2020 Dec 15;324(23):2383-2395.

Key Points

  • Compared ininitial treatment with intravitreal aflibercept versus vitrectomy with panretinal photocoagulation with vitreous hemorrhage secondary to proliferative diabetic retinopathy
  • 205 patients at 39 DRCR sites
  • No significant difference in primary outcome of mean visual acuity letter score over 24 weeks, though vitrectomy eyes had earlier improvement in vision and the authors note the study may have been underpowered to detect the benefit of early vitrectomy
  • Over 2 years, 33% of eyes assigned to aflibercept received vitrectomy, 32% of eyes assigned to vitrectomy received subsequent aflibercept
  • Objective

    To compare initial treatment with intravitreal aflibercept versus pars plana vitrectomy with panretinal photocoagulation for vitreous hemorrhage from proliferative diabetic retinopathy


    Randomized clinical trial at 39 DRCR sites in US and Canada

  • Duration

    24 weeks primary study, planned secondary endpoints out to 2 years

Clinical Trial Guide Video Thumb Watch VBS members discuss this study on New Retina Radio Journal Club

With Aleksandra Rachitskaya, MD; Mrinali Gupta, MD; Eric Nudleman, MD, PhD; and Aris Thanos, MD


Of note, prior treatment of PDR with injections or PRP did not preclude enrollment


Randomized 1:1 (1 eye per patient) to

(a) Intravitreal 2mg aflibercept at enrollment then q 4 weeks for 4 months

(b) Prompt vitrectomy with panretinal photocoagulation

Both groups could receive rescue PPV or aflibercept during the follow-up based on specific criteria


Study population

Visual acuity end-points

Recurrent Vitreous Hemorrhage

Exploratory Outcome- DME

Adverse events