"A clinical trial among more than  patients has found that the drug ranibizumab Lucentis is highly effective in treating proliferative diabetic retinopathy PDR a complication of diabetes that can severely damage eyesight. The results published by the Journal of the American Medical Association demonstrate the first major therapy advance for the condition in nearly  years. Funded by the National Eye Institute NEI and conducted by the Diabetic Retinopathy Clinical Research Network DRCR.net the trial compared Lucentis injections with a type of laser therapy called panretinal photocoagulation which has remained the gold standard for PDR since the mids. Although laser therapy preserves central vision it can damage night and side vision so researchers have sought therapies that lack these side effects. The trial results provide crucial evidence for a safe and effective alternative to laser therapy against PDR said NEI Director Paul A. Sieving M.D. Ph.D. Patients who received Lucentis showed a little bit better central vision much less loss of their side vision and substantially less risk for surgery than patients who received laser treatment said Lloyd Paul Aiello M.D. Ph.D. director of the Beetham Eye Institute at Joslin Diabetes Center and Professor of Ophthalmology at Harvard Medical School. These findings will change the available treatment options for patients with PDR. Diabetic retinopathy damages blood vessels in the lightsensitive retina in the back of the eye. As the disease worsens blood vessels can swell and lose their ability to function properly. Diabetic retinopathy becomes proliferative when lack of blood flow in the retina increases production of a protein called vascular endothelial growth factor VEGF which can stimulate the growth of new abnormal blood vessels. These new vessels are prone to bleeding into the center of the eye sometimes requiring a surgical procedure called a vitrectomy to clear the blood. The abnormal blood vessels can also cause scarring and retinal detachment. Untreated PDR is associated with high risk of visual loss. Lucentis is among several drugs that block the effects of VEGF. Dr. Aiello and George King M.D. Chief Scientific Officer at Joslin Diabetes Center and Professor of Medicine at Harvard Medical School pioneered the study of VEGF in diabetic eye disease beginning in the early s. Their work followed a distinguished Joslin traditionthe basic laser photocoagulation technique was developed in the s by Dr. Aiellos father Lloyd M. Aiello M.D. and grandfather William P. Beetham M.D. About . million U.S. residents have diabetic retinopathy a leading cause of blindness among workingage Americans. Among these about . percent have progressed to PDR.  The DRCR.net enrolled  participants  eyes with PDR in one or both eyes at  clinical sites across the country. Eyes were assigned randomly to treatment with Lucentis or laser. About half of the eyes assigned to the laser group required more than one round of laser treatment. In the other group Lucentis was injected into the eye once per month for three consecutive months and then as needed until the disease resolved or stabilized.  Because Lucentis is commonly injected to treat diabetic macular edema DMEa buildup of fluid in the center of the retinathe study permitted the use of Lucentis for DME in the laser group if necessary. Slightly more than half  percent of eyes in the laser group received Lucentis injections to treat DME. About  percent of eyes in the Lucentis group received laser therapy mostly for issues other than DME. At two years vision in the Lucentis group improved by an average of about half a line on an eye chart compared with virtually no change in the laser group.  Participants treated with laser generally lost substantial peripheral vision but those given injections did not emphasized Jennifer Sun M.D. M.P.H. Associate Professor of Ophthalmology at Harvard Medical School and physician at the Beetham Eye Institute. This was a clear benefit associated with the antiVEGF medication said Dr. Sun who as the DRCR.net nationwide Protocol Working Investigator was instrumental in the studys development. Many of our patients who have laser treatment notice that they have more tunnel vision which can lead to difficulties as they go about activities of daily life. The use of antiVEGF treatment rather than laser for PDR could help prevent these symptoms. Additionally the need for vitrectomy surgery was lower in the Lucentis group  of  eyes than in the laser group  of  eyes.  Overall the drugs benefits are particularly clear for people with both PDR and DME. We know that this drug will help treat both conditions at the same time so this is an especially appealing treatment alternative for these patients Dr. Aiello noted. Lucentis should be considered a viable treatment option for people with PDR especially for individuals needing antiVEGF for DME said Jeffrey G. Gross M.D. of the Carolina Retina Center in Columbia South Carolina who chaired the clinical study. The study also suggested that Lucentis may help prevent DME. Among people without this condition at the start of the study only  percent of Lucentistreated eyes developed it compared with  percent in the laser group. Scientists will follow up on that result as the DRCR.net continues to track patients for a total of five years.  A separate clinical trial now getting underway will examine whether antiVEGF injections given at an earlier stage of diabetic eye disease can help prevent people from developing both DME and the sightthreatening PDR stage of the disease at all Dr. Aiello said. The trial reported today is a major study that may substantially change our approach to treatment of PDR summed up Dr. Sun. Laser still has a role in the treatment of PDR for some patients but antiVEGF therapy gives us another tool in our search for better vision outcomes in our patients with diabetes. About Joslin Diabetes Center Founded in  Joslin Diabetes Center is worldrenowned for its deep expertise in diabetes treatment and research. Joslin is an independent nonprofit institution affiliated with Harvard Medical School and a federallydesignated Diabetes Research Center. Joslin is dedicated to finding a cure for diabetes and ensuring that people with diabetes live long healthy lives. We develop and disseminate innovative patient therapies and scientific discoveries throughout the world. Our mission is to prevent treat and cure diabetes. Our vision is a world free of diabetes and its complications. For more information visit  http About Joslin Research Joslin Research comprises the most comprehensive and productive effort in diabetes research under one roof anywhere in the world. With plus facultylevel investigators Joslin researchers focus on unraveling the biological biochemical and genetic processes that underlie the development of type  and type  diabetes and related complications.  Joslin research is highly innovative and imaginative employing the newest tools in genetics genomics and proteomics to identify abnormalities that may play a role in the development of diabetes and its complications. Joslin Clinic patients and others with diabetes have the option of participating in clinical trials at Joslin to help translate basic research into treatment innovations.  Joslin has one of the largest diabetes training programs in the world educating  M.D. and Ph.D. researchers each year many of whom go on to head diabetes initiatives at leading institutions all over the globe. For more information visit  http"