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The purpose of this study is to determine whether topical nepafenac (qid) is effective in preventing and treating macular thickening related pan-retinal photocoagulation in patients with diabetic retinopathy.

Objective: To evaluate the effect of topical nepafenac 0.1 %, in preventing and in treating macular thickening related to pan-retinal photocoagulation in diabetic patients. Material and methods: This is a prospective, longitudinal, and controlled study in patients with diabetic retinopathy (severe non-proliferative and proliferative retinopathy), with a symmetric severity in both eyes and without a clinical significant macular edema. The best corrected visual acuity (BCVA) in all patients was 20/80 or better. All patients will undergo pan-retinal photocoagulation in three different sessions (with 2 weeks in apart between them). Each patient will receive topical nepafenac 0.1% (qid) on one eye, and placebo (qid) at the fellow eye, starting 1 week before the first retinal photocoagulation session and continued for 9 weeks ( ending 4 weeks after pan-retinal photocoagulation is completed). Spectral domain OCT and BCVA in ETDRS scale will be performed before and at 2 weeks after each laser session, and at 1, 2 and 3 months after treatment completed. BCVA and OCT outcomes of each studied period will be compared on both eyes, and side effects will be recorded.

Inclusion Criteria:

• Patients with Severe and proliferative Diabetic Retinopathy
• Symmetric severity grade on both eyes
• Best corrected visual acuity better than 20/80

Exclusion Criteria:

• Clinical significant macular edema
• Lens opacity
• Ocular surgery 6 months or less before recruit
• Uveitis history
• Actual use of topical or systemic non-steroidal anti inflammatory agents
• Actual or history of other macular diseases
• Ocular surface diseases
• Vitreomacular traction syndrome
• Other vascular retinal diseases different to diabetic retinopathy
• Actual or history of use of topical prostaglandin analogues