Protocol S by DRCR.net has shown that receive Ranibizumab as anti-vascular endothelial growth
factor (anti-VEGF) therapy with deferred panretinal photocoagulation (PRP) are non-inferior
to those in eyes that receive standard prompt PRP therapy, however with some visual
functional benefits and less complications with Ranibizumab arm.
Applying Protocol S in real world scenario may add cost burden to the patient as patients
need about 7 injections per year which will cost the patient about 7000 US dollars a year as
minimum The primary objective of this protocol is to determine the visual acuity outcomes at
1 year in eyes with proliferative diabetic retinopathy (PDR) using Bevacizumab 1.25 mg
instead of Ranbizumab to lower the cost burden