Diabetic Retinopathy: Assessing the Armamentarium for Improved Detection and Treatment
This activity is supported by an educational grant from Genentech, Inc.
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The correct answer is C.
Rationale: OCT angiography (OCTA) detects typical diabetic changes before they are visible clinically. OCTA is an emerging modality for vascular structure assessment and nonperfusion evaluation that;
- Reconstructs vascular flow patterns
- Combines structural and functional feedback
- Provides novel information compared to both conventional OCT and fluorescein angiography
- But does not provide leakage information
The correct answer is A.
Rationale: In Protocol S, visual acuity in most study eyes that completed follow-up was very good at 5 years and was similar in both groups. Severe vision loss or serious PDR complications were uncommon with PRP or ranibizumab. However, the ranibizumab group had lower rates of developing vision-impairing diabetic macular edema and less visual field loss. Patient-specific factors, including anticipated visit compliance, cost, and frequency of visits, should be considered when choosing treatment for patients with PDR. These findings support either anti-vascular endothelial growth factor therapy or PRP as viable treatments for patients with PDR.
Reference: Gross JG, et al. JAMA Ophthalmol. 2018;136(10):1138-48.
The correct answer is B.
Rationale: Despite the significant reduction in DR in patients with good glycemic control, DR develops even in that setting and is independently associated with disease duration. Anti-VEGF therapy would be the most prudent approach in this patient with proliferative retinopathy.