Recent research is providing important new insights into the pathology and progression of diabetic retinal disease. During the symposium Diabetes Retinal Disease—Changing Before Your Eyes, a panel of experts will discuss how these insights may translate to the clinic, including a new understanding of how early detection and treatment may delay or prevent severe complications. The two-hour session will begin at 4:30 p.m. ET Sunday, June 27.
Jennifer Sun, MD, MPH, will review current treatment options for preproliferative diabetic retinopathy and the need for updated retinopathy grading scales. Dr. Sun is Associate Professor of Ophthalmology, Harvard Medical School, and Chief of the Center for Clinical Eye Research and Trials of the Beetham Eye Institute, Joslin Diabetes Center.
“We treat eyes when they develop either swelling of the central retina with vision loss, called diabetic macular edema, or when they head into the most advanced level of diabetic retinopathy, which is proliferative diabetic retinopathy, because the risk of moderate to severe vision loss is quite high if you don’t treat those eyes,” Dr. Sun said. “We’ve developed very good therapeutic methods over the years, both laser photocoagulation and, since about 2010, the injectable anti-VEGF (vascular endothelial growth factor) agents. The latest frontier in treatment is trying to understand whether earlier treatment is necessary or important to improve patient outcomes.”
Results from two major studies suggest that starting anti-VEGF injections early, when eyes have moderate to severe nonproliferative disease, can help prevent the development of either diabetic macular edema or proliferative retinopathy.
“But interestingly, we haven’t seen major differences in terms of visual acuity results over two years in either of these studies,” Dr. Sun said. “One of these studies is still ongoing, so there are still some unanswered questions as to whether early prevention of these eye complications will be beneficial in the longer term for vision.”
Dr. Sun also will discuss newly launched initiatives to update the current grading scales used to judge the severity of diabetic eye disease. The grading scales were initially proposed in the late 1960s and were subsequently modified and validated by studies such as the Early Treatment Diabetic Retinopathy Study (ETDRS).
In another presentation, Patrice E. Fort, PhD, MS, Associate Professor of Ophthalmology and Visual Science, University of Michigan Kellogg Eye Center, will discuss retinal neurovascular degeneration in diabetes.
“There has been a very large amount of work to try to understand diabetic retinopathy and its pathophysiological mechanism using different models, whether they’re cell or animal models, but unfortunately with mixed results, in big part due to the limitations of those models,” Dr. Fort said. “Our work over the last few years has been focused on trying to understand the human pathophysiology by analyzing human tissues rather than tissues from animal models or cell culture.”
The potential treatment implications are huge, Dr. Fort continued.
“This approach is potentially a game changer as it allows us to directly analyze and understand the human pathology, specifically identifying new pathways and new potential therapeutic targets that are involved in the onset and progression of diabetic retinopathy,” Dr. Fort said.
Also during this session, Stela Vujosevic, MD, PhD, FEBO, Head of Medical Retina Service, University Hospital Maggiore della Carità, Novara, Italy, will discuss the clinical aspects of retinal neurovascular degeneration in diabetes, and Jinan B. Saddine, MD, MPH, Centers for Disease Control and Prevention, National Vision Program, will discuss diabetic retinopathy in youth with diabetes.