VIDEO: Treatment options for diabetic eye disease

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

We think about diabetic eye disease or diabetic retinopathy in really two manifestations. One is diabetic macular edema or swelling, plasma fluid swelling within the central part of the retina called the macula. When you have an excess of plasma fluid swelling of the macula, that can compromise central vision. So for center-involving disease, we do pharmacotherapies that are directly injected into the vitreous cavity of the eye. These include as first-line biologic therapies that target VEGF, vascular endothelial growth factor. These medicines are injected approximately every one to two months to try to achieve reduction in the fluid swelling and improvement in vision.

As second-line therapy, we have intravitreal corticosteroids. These are used in many cases where first line anti-VEGF therapies are suboptimal or don't achieve the desired therapeutic response. And then, as an adjunctive treatment, we have laser therapies, which, in the setting of macular edema, are focused on trying to either seal areas of abnormal leakage or potentially improve intrinsic pump function within the retina to try to help clear the fluid.

Briefly, the other aspect of diabetic eye disease is proliferative diabetic disease, and that occurs with more advanced disease, and that's where the disease has progressed to a stage where the normal blood perfusion of the retina has been compromised, and so the body tries to make new vessels. Unfortunately, those vessels are pathologic, that they don't actually help in the function of the eye, and these abnormal or pathologic vessels are prone to breaking, bleeding, and scarring, and that can lead to vision loss in that way. So to treat that, we use a combination of, again, the anti-VEGF medicines to stabilize the disease, and then we'll typically follow up with what we call panretinal photocoagulation, which is laser treatment applied to the part of the retina that's not getting good blood flow to try to decrease the drive for abnormal new vessel formation.