Clinical Studies:


Viet Q. Chau, MD; Bascom Palmer Eye Institute, Miami, FL

Citation: National Library of Medicine (U.S.). (2016, March – 2020, July ). A Phase 3, Double-Masked, Randomized Study of the Efficacy and Safety of Intravitreal Aflibercept Injection in Patients With Moderately Severe to Severe Nonproliferative Diabetic Retinopathy (PANORAMA). Identifier NCT02718326.

Key Points

  • PANORAMA was the first phase 3 randomized, clinical trial intentionally designed to evaluate the efficacy and safety of intravitreal (IVT) anti-VEGF therapy in patients with moderately severe to severe nonproliferative diabetic retinopathy (NPDR) without diabetic macular edema (DME).
  • Sponsored by Regeneron Pharmaceuticals, the trial compared patients receiving sham injection to patients receiving 1 of 2 aflibercept dosing regimens, with primary endpoints at 24 weeks and 52 weeks.
  • Patients receiving aflibercept resulted in regression of NPDR, demonstrated by improvement by ≥2 Steps from baseline in the Diabetic Retinopathy Disease Severity Scale (DRSS) Score at both 24 weeks and 52 weeks.
  • Significant secondary outcomes included less vision threatening complications (such as proliferative diabetic retinopathy (PDR) and anterior segment neovascularization (ASNV)) and less development of DME in patients who received aflibercept injections, regardless of dosing regimen.
  • Objective

    To evaluate the efficacy of IVT aflibercept compared to sham treatment in the improvement of moderately severe to severe NPDR.


    Randomized, multi-center, double-masked, phase 3, interventional clinical trial.



Subjects who met the inclusion criteria were randomly assigned in a 1:1:1 ratio stratified based on their Diabetic Retinopathy Severity Scale (DRESS) score to:


Study population:

Primary Outcomes:

Secondary Outcomes: