DIABETIC RETINOPATHY (DR) IS a leading cause of blindness in US adults. From 2010-50, 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 by Elsevier for the American Academy of Ophthalmology found 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 has sponsored a national educational campaign (noweyesee.com) and RETINA-AI Health has just submitted its Galaxy autonomous screening device for DR to the FDA for clearance.
Eyenuk
The EyeArt AI Eye Screening System is FDA-cleared artificial intelligence technology for autonomous detection of DR.
(818) 835-3585, meyenuk.co
Genentech
A Lucentis injection 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
Retinal 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, along with a detaching vitreous.
optometry.iu.edu
Advertisement
Regeneron Pharmaceuticals
An EYLEA injection 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 blood vessels.
(914) 847-7000, -eylea.us
LumiThera
The Valeda Light Delivery System studies the effects of the device in DME patients.
(844) 342-3333, lumithera.com
Allergan
Ozurdex is a small implant that is injected directly into the back of the eye and slowly releases medication over time without the need for monthly injections.
(844) 639-2246, ozurdex.com
Smart Ways to Discuss Diabetic Retinopathy Treatments
Allen Ho, MDWills Eye Hospital, Philadelphia, PA
Diabetic Retinopathy can progress without symptoms and is the top cause of blindness in working age Americans. Only about half of those with known diabetes get an annual diabetic eye exam with a retina specialist. Our focus should be on communicating with frontline eyecare providers. If we can get to patients in time we can stabilize and reverse damage and sometimes improve vision. Retina specialists have the tools to prevent blindness in about 90% of patients. We can use new injectable medicines like Eylea, Lucentis, Avastin and Ozurdex, and laser and surgical treatments. In the future, AI will help detect who is at risk, say, a patient who is a smoker, obese, has high blood pressure, or lives a sedentary life. New therapies, like gene therapy, are being explored.
A. Paul Chous, ODChous Eye Care Associates, Tacoma, WA
Caring for patients with diabetes is a mainstay of my practice. I try to prevent or delay the development of nonproliferative diabetic retinopathy with good, early metabolic control. Unfortunately, we’re doing a lousy job of getting early, good control in many patients. Once the “horse is out of the barn” and they have moderately severe or worse nonproliferative DR, improved metabolic control has limited effect on outcomes. Then I’ll send them to a retina specialist to see if they may benefit from anti-VEGF therapy. Hopefully, I can introduce them early enough to build rapport before they need invasive treatments like intravitreal injections. Use of red-free and ultrawide-field imaging, along with optical coherence tomography for DME and OCTA for subclinical retinopathy, can help us more accurately detect DR severity. Artificial Intelligence systems available from EyeNuk and others can assist with more accurate grading. Along with patient education and conventional imaging, they may help patients fully appreciate the severity of their condition.
