Experimental Treatments for Diabetic Macular Edema

2011 ◽  
Vol 04 (02) ◽  
pp. 125
Author(s):  
Homayoun Tabandeh ◽  
David Boyer ◽  
◽  
Keyword(s):  
Clinical Trials ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Large Scale ◽  
Case Series ◽  
Treatment Modalities ◽  
Systemic Control ◽  
Experimental Treatments ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) is the most common reason for the loss of reading vision in diabetes patients. Systemic control of blood sugar, blood pressure, and lipids is an important aspect of the management of DME. In these patients, macular laser photocoagulation has been shown to reduce the incidence of moderate visual loss by 50 %. Significant visual improvement occurs in a small minority. Other treatment modalities, such as intravitreal steroids and anti-vascular endothelial growth factor (VEGF) drugs, have become increasingly popular. Case series and small clinical studies are suggestive of a beneficial effect, while large-scale clinical trials are ongoing. Currently, it appears that macular laser photocoagulation remains the gold standard for the treatment of DME. Intravitreal steroids and anti-VEGF agents are useful adjuncts that may improve visual outcomes. Current treatments and ongoing clinical trials are discussed.

scholarly journals Anti-angiogenic therapy for diabetic macular edema

2018 ◽  
Vol 11 (4) ◽  
pp. 51-66
Author(s):  
Fedor E. Shadrichev ◽  
Nyurguyana N. Grigor'eva ◽  
Elizaveta S. Rozhdestvenskaya
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Severe Disease ◽  
Diabetic Patients ◽  
Vegf Inhibitors ◽  
Angiogenic Therapy ◽  
Examination Quality ◽  
Endothelial Growth Factor

Diabetic retinopathy remains one of the greatest challenges for healthcare system worldwide despite the fact that the incidence of visual acuity impairment in diabetic population has decreased due to examination quality improvement and dynamic observation of patients. Visual acuity impairment in diabetic patients is often related to diabetic macular edema. Until recently, laser photocoagulation of the retina was regarded as gold standard for diabetic macular edema treatment. Laser photocoagulation of the retina provides visual acuity stabilization rather than improvement. Since early 2000s, pharmacological approach to this severe disease has been established. As vascular endothelial growth factor (VEGF) is one of the crucial factors involved in the pathogenesis of diabetic retinal disorders, VEGF inhibitors are now recognized as a treatment of choice for diabetic macular edema. This article considers results of different clinical trials investigating anti-VEGF therapy efficacy in DME treatment.

scholarly journals Review on Recent Trials Evaluating the Effect of Intravitreal Injections of Anti-VEGF Agents on the Macular Perfusion of Diabetic Patients with Diabetic Macular Edema

2020 ◽  
Vol 15 (3) ◽  
pp. 188-198
Author(s):  
Ayman G. Elnahry ◽  
Ahmed A. Abdel-Kader ◽  
Ahmed E. Habib ◽  
Gehad A. Elnahry ◽  
Karim A. Raafat ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Case Series ◽  
Diabetic Patients ◽  
Long Term Effects ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Anti Vegf

Background: Diabetic macular edema (DME) is a major cause of vision loss in diabetics worldwide. Anti-vascular endothelial growth factor (anti-VEGF) agents have become the mainstay of treatment of vision loss due to DME. Long-term effects of these agents on the macular perfusion (MP) are a current concern. Objective: To review recently published studies that evaluated the effect of intravitreal injection of anti-VEGF agents on the MP of diabetics with DME. Methods: Different databases were searched including PubMed, Medline, Ovid, Science Direct, and Google Scholar for relevant studies published between 2010 and 2019. All studies found were compared regarding methodology and results and included in this review. Some studies relating to retinal perfusion in general and not strictly MP were also included for comprehensiveness. Results: Several studies utilizing different anti-VEGF agents were identified. All the large randomized controlled clinical trials identified utilized primarily fluorescein angiography (FA) and human graders and found generally no worsening of MP associated with anti-VEGF agents use in diabetic patients with DME. Some of these studies, however, depended on post-hoc analysis. Several more recent, but smaller case series, have utilized the relatively new and non-invasive optical coherence tomography angiography (OCTA) in this evaluation and found more conflicting results. Conclusion: The large clinical trials recently performed depended mainly on FA in the analysis of MP changes following injections and generally found no worsening of MP. More recently, smaller case series have utilized OCTA in this analysis, yielding more conflicting results. Large randomized controlled trials using OCTA are thus needed.

scholarly journals Clinical Characteristics of Patients with Newly Diagnosed Diabetic Macular Edema in Turkey: A Real-Life Registry Study—TURK-DEM

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Bora Eldem ◽  
Sengul Ozdek ◽  
Ali Osman Saatci ◽  
Emin Ozmert ◽  
Esat Ulay ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Large Scale ◽  
Real Life ◽  
Diagnostic Methods ◽  
Newly Diagnosed ◽  
Anti Vegf ◽  
Diagnostic Characteristics ◽  
The Right

Purpose. To evaluate the clinical and diagnostic characteristics of patients with newly diagnosed diabetic macular edema (DME) in Turkey in a real-life setting. Methods. A total of 945 consecutive patients (mean (SD) age: 61.3 (9.9) years, 55.2% male) with newly diagnosed DME were included. Data on patient demographics, comorbidities, ocular history, ophthalmic examination findings including type of DME, central macular thickness (CMT) via time domain (TD) and spectral domain (SD) optical coherence tomography (OCT), and planned treatments were recorded. Results. OCT (98.8%) and fundoscopy (92.9%) were the two most common diagnostic methods. Diffuse and focal DMEs were detected in 39.2% and 36.9% of cases, respectively. Laser photocoagulation (32.1%) and antivascular endothelial growth factors (anti-VEGF; 31.8%) were the most commonly planned treatments. The median CMT in the right eye was significantly greater in untreated than in treated patients [376.5 μm (range: 160–840) versus 342 μm (range: 146–999) (p=0.002)] and in the left eye [370 μm (range: 201–780) versus 329 μm (range: 148–999) (p<0.001)]. Conclusions. This study is the first large-scale real-life registry of DME patients in Turkey. SD-OCT and fundoscopy were the most common diagnostic methods. Laser photocoagulation and anti-VEGF therapy were the most common treatments.

VISUAL OUTCOME IN DIABETIC MACULAR EDEMA AFTER GRID LASER TREATMENT

2016 ◽  
Vol 23 (04) ◽  
pp. 478-483
Author(s):  
Muhmmad Jameel Shahid ◽  
Faheem Ahmad ◽  
Muhammad Asif ◽  
Muhmmad Nabeel Sultan
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Visual Outcome ◽  
Blood Retinal Barrier ◽  
Department Of Ophthalmology

Regarding the causes of blindness, Diabetic retinopathy is a one the majorcause of blindness in all types persons from both industrialized and developing countries.Due to inadequate eating habits, prevalence of diabetic retinopathy is increasing. Both focaland diffuse leakage from retinal capillaries can cause Diabetic macular edema. Varioustreatment modalities for macular photocoagulation are focal laser, Grid laser and modified gridused in patients having diabetic macular edema Study Design: Prospective, interventional,noncompetitive case series. Setting: Department of Ophthalmology, Allied Hospital andDepartment of Ophthalmology, Divisional Headquarter Hospital Faisalabad. Period: One yearfrom April 2012 to April 2013. Materials and Methods: A total of 200 eyes of 200 patientswith clinical significant macular edema that met the inclusion criteria were enrolled. Results: Inthis study, 200 patients with diabetic macular edema were studied. Of these 121 (60.5%) weremales and 79 (39.5%) females with mean age of 38.52 years (SD 7.512, Range 25-50 years).All patients had diffuse, clinically significant macular edema at baseline for which they hadreceived grid laser photocoagulation. Discussion: In recent past number of diabetic patientsall over the world has increased that has caused increase incident of diabetic retinopathy .Soin patients having diabetic retinopathy, macular edema can cause deterioration in visual acuityduring any stage of diabetic retinopathy. The pathogenesis of Diabetic macular edema (DME)is the disruption of inner blood – retinal barrier that is known to be associated with metabolicalteration affecting the retinal pigment epithelium or retinal vascular endothelium. Focal and/orgrid laser photocoagulation is being considered as the treatment of DME. Conclusion: Macularphotocoagulation was found to be an effective method of treatment for CSME among diabeticpatients, which has resulted in a positive visual outcome in 87% of the patients (stable andimproved vision).

Role of Systemic Control Prior to Laser Photocoagulation in Diabetic Macular Edema

2011 ◽  
Vol 1 ◽  
pp. 58-62
Author(s):  
Vishali Gupta ◽  
Deeksha Katoch ◽  
Anil Bhansali ◽  
Swapnil Parchand ◽  
Amod Gupta
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Systemic Control

scholarly journals Update on the Management of Diabetic Macular Edema

2017 ◽  
Vol 10 (01) ◽  
pp. 52
Author(s):  
Shawn M Iverson ◽  
W Lloyd Clark ◽  
◽  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Options ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Clinical Practices ◽  
Working Age ◽  
Endothelial Growth Factor ◽  
Review Current

Diabetic macular edema (DME) is a treatable sequela of diabetic retinopathy and a significant cause of visual morbidity among working age individuals worldwide. While anti-vascular endothelial growth factor (anti-VEGF) agents are first-line agents in the management of DME, corticosteroids and laser therapy can play a role as well. Despite a growing understanding of best clinical practices, many patients respond unpredictably to therapy. This article will briefly review current treatment modalities and discuss future treatment options for managing DME.

scholarly journals Anti-VEGF for the Management of Diabetic Macular Edema

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Francisco Rosa Stefanini ◽  
Emmerson Badaró ◽  
Paulo Falabella ◽  
Michael Koss ◽  
Michel Eid Farah ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Cochrane Library ◽  
Public Health Issue ◽  
Anti Vegf ◽  
Significant Public Health ◽  
Endothelial Growth Factor

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 20 and 60 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significant public health issue. Macular photocoagulation has been the standard treatment for this condition reducing the risk of moderate visual loss by approximately 50%. The role of vascular endothelial growth factor (VEGF) in DR and DME pathogenesis has been demonstrated in recent studies. This review addresses and summarizes data from the clinical trials that investigated anti-VEGF for the management of DME and evaluates their impact on clinical practice. The literature searches were conducted between August and October 2013 in PubMed and Cochrane Library with no date restrictions and went through the most relevant studies onpegaptanib,ranibizumab,bevacizumab, andafliberceptfor the management of DME. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an option that must be considered for the treatment of DME.

scholarly journals Combination Therapy for Diabetic Macular Edema

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Dinah Zur ◽  
Anat Loewenstein
Keyword(s):  
Clinical Trials ◽  
Combination Therapy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Visual Loss ◽  
Diabetic Patients ◽  
Combination Therapies ◽  
Revolutionary Change ◽  
Intravitreal Treatment

Diabetic macular edema is a main reason for visual loss in diabetic patients. Until recent years, macular laser photocoagulation was the only available therapy. The awareness that inflammation is an important factor in the pathogenetic process of DME gave reason for intravitreal treatment with corticosteroids. The introduction of anti-VEGF drugs brought a revolutionary change in the treatment of DME. This paper will review the important clinical trials with an emphasis on combination therapies.

Sign in / Sign up

Export Citation Format

Share Document