These novel strategies may change DME treatment paradigmThere is subset of patients with resistant or persistent DME that forms the impetus for new treatment strategies, including next-generation anti-VEGF-A and new classes of drugs. Pravin U. Dugel, MD, outlines a list of potential treatment candidates that may lead that paradigm shift.
Vitrectomy offers a viable therapeutic option for DMEMaurice B. Landers III, MD, presents an argument that in an era when pharmacological therapy has become the mainstay for the treatment of diabetic macular edema (DME), pars plana vitrectomy (PPV) deserves consideration as a reasonable alternative for early DME in appropriate patients.
Partner Perspective: Patient Case Study - CONTINUOUS MICRODOSING™ TREATMENT WITH ILUVIEN® (fluocinolone acetonide intravitreal implant) 0.19mg
Treat-and-extend protocol reduces burden of anti-VEGF treatment for DMEResults of the prospective TREX-DME study provide an evidence base for using a treat-and-extend protocol for administering anti-VEGF injections for eyes with diabetic macular edema.
Suprachoroidal corticosteroid shows visual, anatomic improvements in DME eyesSuprachoroidal triamcinolone acetonide (CLS-TA, Clearside Biomedical) injection resulted in visual and anatomic improvements in eyes with diabetic macular edema, particularly in those that were treatment-naïve. Multiple injections of the investigational treatment were well-tolerated and associated with a low incidence of IOP elevation.
Sustained drug-delivery technologies shape promising futureDevelopment of technologies for sustained drug delivery is a topic of great interest among retina specialists considering the number of chronic conditions that are managed with repeated intravitreal injections.
Phase IV study shows improved DME outcomes with fluocinolone acetonide implantThe fluocinolone acetonide 0.2 mcg/day implant (Iluvien, Alimera Sciences) offers an additional option for treating diabetic macular edema that reduces the need for subsequent therapy with anti-vascular endothelial growth factor or steroid treatment.
Outcomes differ from trials with ‘real-world’ anti-VEGF therapy for DMEThe visual outcomes after anti-VEGF therapy administered to treat diabetic macular edema in the “real world” do not achieve those reported in randomized clinical trials. Eyes with better baseline visual acuity are disproportionately affected.
Novel DME treatment derives from multimodal activityALG-1001 is an integrin receptor inhibitor that acts to stabilize the retina’s response to diabetes-related hypoxic and oxidative stress, mitigating production of a host of molecules involved in the development of diabetic macular edema.
Nailing intravitreal implant injections
Nailing intravitreal implant injectionsTreating 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.
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