The scientific community knows that vascular endothelial growth factor (VEGF) causes increased, vascular permeability, resulting in diabetic macular edema (DME) in the ischemic retina, but how to stop the VEGF drive remains the challenge.
The Diabetic Retinopathy Clinical Research Network’s (DRCR.net) Protocol T—the first head-to-head-to-head comparison among aflibercept (Eylea, Renegeron Pharmaceuticals), ranibizumab (Lucentis, Genentech), and bevacizumab (Avastin, Genentech)—found in its first-year results that all three agents improved vision and reduced edema effectively.
As retinal specialists, we are truly fortunate to live in a time where we have several treatment options for patients with diabetic macular edema (DME). A fluocinolone acetonide (FAc) intravitreal implant 0.19 mg (Iluvien, Alimera Sciences) is indicated for the treatment of DME in patients who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in IOP.
Sustained intraocular delivery of fluocinolone acetonide (FAc) using the FAc 0.19 mg intravitreal implant (Iluvien, Alimera Sciences) improves and slows progression of diabetic retinopathy (DR), according to findings of post-hoc analyses of data from the pivotal Fluocinolone Acetonide for Diabetic Macular Edema (FAME) trials.
Abicipar pegol (Allergan/Molecular Partners) met its primary and key secondary endpoints and demonstrated an acceptable overall safety profile in a phase II trial investigating use of the novel anti-VEGF-A agent for treatment of diabetic macular edema (DME).
Treating diabetic macular edema (DME) has evolved from the ETDRS-style focal/grid laser being the standard of care since 1985 to the modern era of pharmacotherapy—with anti-vascular endothelial growth factor (VEGF) injections now taking center stage as primary treatment for most patients.
Researchers have identified a new biomarker they believe can be used as a predictor of vision change in patients with diabetic macular edema, either during the natural history of the disease or after undergoing anti-VEGF therapy. The biomarker is disorganization of the retinal inner layers, or DRIL.
When it comes to finding new treatments for diabetic macular edema (DME), there is no shortage of promising targets, said Peter A. Campochiaro, MD. He presented an overview of future compounds with various mechanisms of action that may change how clinicians treat DME.
Well tolerated and effective, anti-VEGF therapy is the current gold standard to treat DME. However, one treatment simply does not fit all and VEGF may just be one piece of a much larger puzzle. The fact that some DME patients have a limited response to anti-VEGF therapy is representative of this concept; we are discovering that there are additional inflammatory mediators that may be crucial components to the DME picture.