### Can Early Anti-VEGF Injections Prevent Vision Loss in Diabetic Retinopathy? A recent study published in JAMA explored whether early treatment with anti-VEGF injections could prevent vision loss in people with diabetic retinopathy. The study involved 328 adults with type 1 or type 2 diabetes who had early-stage eye disease, known as nonproliferative diabetic retinopathy (NPDR). This condition occurs when blood vessels in the retina weaken and leak fluid, potentially leading to vision loss. In the study, participants were randomly assigned to receive either the anti-VEGF drug aflibercept (Eylea) or a placebo solution and were followed for up to four years. The results showed that those who received the anti-VEGF injections had less structural damage to their eyes compared to those who received the placebo. However, the injections did not significantly prevent vision loss. Dr. Jennifer K. Sun, the senior author of the study, noted that while early anti-VEGF treatment provided an anatomical benefit, it did not improve visual acuity. Therefore, the risks and inconvenience of repeated injections might not be justified for NPDR patients. Although the risk of complications per injection is low, it increases with each additional injection. Dr. Christina Y. Weng, who was not involved in the study, mentioned that while injecting anti-VEGF drugs is generally safe, there are small risks of side effects such as severe inflammation, retinal detachment, and vision loss. These risks compound over time with each injection. The study also raised questions about whether similar results would be seen with other anti-VEGF drugs like bevacizumab (Avastin) and ranibizumab (Lucentis). Previous research suggests that these drugs yield similar results for other conditions like diabetic macular edema, indicating they might also have similar outcomes for preventing vision loss in early-stage diabetic retinopathy. In conclusion, while early anti-VEGF treatment may not be effective in preventing vision loss, patients should consult their doctors to make decisions based on their specific condition and its impact on their daily life. There may still be a minority of patients for whom early treatment is beneficial.