DIABETIC RETINOPATHY (DR) IS a leading cause of blindness in American adults. From 2010 to 50, the number of Americans with DR is expected to nearly double, from 7.7 million to 14.6 million. Diabetes can affect the eyes before changes are detectable, so patients may not know damage is occurring until their vision is threatened. This year, a study conducted by Elsevier for the American Academy of Ophthalmology found that a delay in care of just 5.34 weeks in patients requiring intravitreal injections resulted in vision loss. To raise awareness of the link between diabetes and eye health, Regeneron sponsored a national educational campaign (noweyesee.com) and RETINA-AI Health has just submitted its Galaxy stand-alone screening device for DR to the FDA for clearance.
The EyeArt AI Eye Screening System is an FDA-cleared artificial intelligence technology for autonomous DR detection.
(818) 835-3585, meyenuk.co
One injection of Lucentis can treat all forms of DR in people with or without diabetic macular edema (DME).
(800) 626-3553, gene.com
Indiana University School of Optometry
Retina research detects biomarkers in four types of diabetic eyes using specialized optical techniques. Clockwise from top left: typical DME; significant pathological changes; retina with normal retinal thickness and minimal diabetic changes; traction, accompanied by vitreous detachment.
An injection of EYLEA every 16 weeks is designed to block the growth of new blood vessels in the eye and decrease the ability of fluid to pass through the blood vessels.
(914) 847-7000, -eylea.us
The Valeda Light Delivery System is studying the effects of the device in patients with DME.
(844) 342-3333, lumithera.com
Ozurdex is a small implant that is injected directly into the back of the eye and slowly releases the drug over time without the need for monthly injections.
(844) 639-2246, ozurdex.com
Smart ways to chat Treatments for diabetic retinopathy
Allen Ho, MDWills Eye Hospital, Philadelphia, Pennsylvania
Diabetic retinopathy can progress without symptoms and is the leading cause of blindness in working-age Americans. Only about half of people with known diabetes have an annual eye exam with a retina specialist. We should focus on communicating with frontline eye care providers. If we can reach patients in time, we can stabilize and reverse damage and sometimes improve vision. Retina specialists have the tools to prevent blindness in approximately 90% of patients. We can use new injectable drugs like Eylea, Lucentis, Avastin and Ozurdex, as well as laser and surgical treatments. In the future, AI will help detect people at risk, for example a patient who is a smoker, obese, has high blood pressure, or lives a sedentary lifestyle. New therapies, such as gene therapy, are being explored.
A. Paul Chous, ODChous Eye Care Associates, Tacoma, WA
The care of diabetic patients is a pillar of my practice. I try to prevent or delay the development of non-proliferative diabetic retinopathy with good early metabolic control. Unfortunately, we fail to achieve good early control in many patients. Once the “horse is out of the stable” and has moderately severe or worse non-proliferative DR, improving metabolic control has a limited effect on outcomes. Then I will send them to a retina specialist to see if they can benefit from anti-VEGF treatment. Hopefully I can introduce them early enough to establish a relationship before they need invasive treatments like intravitreal injections. The use of red-free and ultra-widefield imaging, as well as optical coherence tomography for DME and OCTA for subclinical retinopathy, can help us more accurately detect the severity of DR. Artificial intelligence systems available from EyeNuk and others can help with more accurate grading. Along with patient education and conventional imaging, they can help patients fully appreciate the seriousness of their condition.