Prof. Koss highlights the multifactorial nature of DME including mediators beyond VEGF, and the limitations of targeting a single mediator.1/3 Next Interview
Dr Berger describes the current standard of care for DME and its limitations, in addition to a typical patient’s anti-VEGF dosing schedule and strategies to improve treatment adherence.2/3 Next Interview
Dr Berger outlines the typical patient journey for DME, the impact of comorbidities and the burden of frequent anti-VEGF treatment visits, in addition to the potential of a less frequent dosing schedule to reduce burden.3/3 Leave Feedback
Overview & Learning Objectives
Current standard of care treatment for DME using anti-VEGF therapy is limited by targeting a single disease mediator,1–3 less consistent real-world vision gains compared with clinical trials,4–6 and the burden of treatment for patients and caregivers.7 We interviewed leading experts about emerging mediators of DME pathology, the reasons for the gap between controlled trials and clinical practice, and what aspects of treatment are most burdensome to patients and caregivers, in addition to what strategies can be used to improve outcomes.
After watching this activity, participants should be better able to:
- To describe the multifactorial nature of DME beyond the VEGF pathway.
- To understand why there is an efficacy ceiling and a disconnection between real-world outcomes and clinical trials.
- To recognise the burden for the patients and healthcare systems of current treatment options including high frequency of injections to maintain vision gains.
- Urias EA, Urias GA, Monickaraj F, et al. Novel therapeutic targets in diabetic macular edema: Beyond VEGF. Vision Res 2017;139:221-7.
- Das A, McGuire PG, Rangasamy S. Diabetic Macular Edema: Pathophysiology and Novel Therapeutic Targets. Ophthalmology 2015;122(7):1375-94.
- Browning DJ, Stewart MW, Lee C. Diabetic macular edema: Evidence-based management. Indian J Ophthalmol 2018;66(12):1736-50.
- Ciulla TA, Pollack JS, Williams DF. Visual acuity outcomes and anti-VEGF therapy intensity in diabetic macular oedema: a real-world analysis of 28 658 patient eyes. Br J Ophthalmol 2021;105(2):216-21.
- Sivaprasad S, Ghanchi F, Kelly SP, et al. Evaluation of standard of care intravitreal aflibercept treatment of diabetic macular oedema treatment-naive patients in the UK: DRAKO study 12-month outcomes. Eye (Lond) 2022;36(1):64-71.
- Van Aken E, Favreau M, Ramboer E, et al. Real-World Outcomes in Patients with Diabetic Macular Edema Treated Long Term with Ranibizumab (VISION Study). Clin Ophthalmol 2020;14:4173-85.
- Sivaprasad S, Oyetunde S. Impact of injection therapy on retinal patients with diabetic macular edema or retinal vein occlusion. Clin Ophthalmol. 2016;10:939-46