First-line treatment for diabetic macular edema (DME) is overwhelmingly anti-vascular endothelial growth factor (VEGF) drugs, with more than two-thirds of clinicians around the world prescribing them for this patient population.
Retinal vein occlusions (RVOs) are a frequent cause of retinal vascular disease in patients older than 50 years.
With advances in local treatment of uveitis over the past decade, the therapeutic armamentarium has increased from depot injections with short-lasting activity to long-term treatments, said Thomas A. Albini, MD.
In patients with age-related macular degeneration managed by a treat-and-extend regimen, the visual acuity generally was maintained; lesion reactivation occurred frequently at about eight weeks; and longer induction phases between treatments was associated with worse outcomes.
Quantitative assessment of retinovascular features on ultra-widefield angiography images showed significant improvements in leakage and ischemia following treatment with aflibercept in patients with diabetic macular edema and retinal vein occlusion.
The metastatic prognosis does not increase when vitrectomy is performed at the time of brachytherapy.
The 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.
The 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.
Patients with diabetic retinopathy have a high risk of developing macular edema after cataract surgery. Intravitreal injections of aflibercept might result in fewer patients developing macular edema in this patient population.
ALG-1001 (Luminate, Allegro Ophthalmics) has a number of different mechanisms of action that benefit patients chronically treated with anti-vascular endothelial growth factor drugs and those who are treatment naïve.