DR/DME: Ongoing Clinical Trials and New Diagnostic Tools


Carolyn Majcher, OD, FAAO, and Rishi Singh, MD, discuss new and upcoming clinical trials, investigational therapies, and diagnostic tools for the treatment of diabetic retinopathy and diabetic macular edema (DR/DME).

Carolyn Majcher, OD, FAAO: Which ongoing clinical studies and investigative therapies that we haven’t already discussed with regard to diabetic retinopathy and diabetic macular edema [DME] are you excited about at this time?

Rishi Singh, MD: There’s a variety of different ones that I think are kind of exciting. The tyrosine kinase inhibitors, which are downstream from the VEGF [vascular endothelial growth factor] receptor molecule. They have a few studies going on right now in the AMD population that easily could be transitioned over the DME population, which gives potentially greater durability over anti-VEGFs to date, which would be really huge. The inundation of injections in the first few years is significant. Thankfully these new drugs [require less injections], but certainly, if there’s another therapy that might offer the same thing, it might be a better approach.

We’re also looking at other mechanisms of action including photobiomodulation. This is a light-based therapy for patients. It’s been piloted and tested and approved in Europe for this condition. The United States obviously lags behind because we look for evidence [level 1] data, which this does not have at this given state. So [there are] many ongoing studies about photobiomodulation that I think are exciting.

Lastly, when we’re looking at pan-VEGF inhibition, VEGF C and D inhibition alongside VEGF A and B, which we typically know about in our pathological states, mainly at VEGF A, we’re looking to inhibit pan-VEGF B, C, and D in this case to improve our ability to control patients and reduce fluid over time. We’ll learn about that as time goes on as far as what advantages it may have over our current therapies.

Carolyn Majcher, OD, FAAO: Some really exciting therapies on the horizon. Are there any new diagnosis tools for diabetic retinopathy or macular edema that we can expect to hit the market soon that you’re excited about as well?

Rishi Singh, MD: We’re going to see an advent of home OCT [optical coherence tomography]. It will be interesting to see if patients were able to do that before they come in or to monitor when they have severe distortion. They go in front of the OCT, take a picture, and then send it to us. That’s going to be a game changer with regard to how we manage these patients to see if we can potentially monitor them at home. Beyond that, I think that we’re learning a lot about intraoperative maneuvers that we’re doing as surgeons that can help to assist outcomes for patients. That’s really been exciting to see all of that come together.

Carolyn Majcher, OD, FAAO: Well, thank you so much, Dr Singh, for this rich and informative discussion, and I’d like to thank everyone in the audience for tuning in.


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