In the Journals

American Diabetes Association updates guidelines for diabetic retinopathy

The American Diabetes Association updated its guidelines for the diagnosis and treatment of diabetic retinopathy for the first time since its last position statement on the condition in 2002, according to a report.

The American Diabetes Association confirmed the importance of anti-VEGF agents in the treatment of both diabetic macular edema and proliferative diabetic retinopathy. Anti-VEGFs may be a viable alternative or adjunct to panretinal laser photocoagulation in eyes with PDR through at least 2 years.

“However, in applying these findings to clinical practice, factors such as frequency of follow-up, treatment cost and patient preference must be considered in addition to these safety and efficacy outcomes,” the authors wrote.

Focal laser photocoagulation was the primary treatment for clinically significant macular edema. However, new research has shown that anti-VEGF agents can improve visual acuity in eyes with central-involved diabetic macular edema (CIDME).

“There are currently three anti-VEGF agents commonly used to treat eyes with CIDME — bevacizumab, ranibizumab and aflibercept. Of these anti-VEGF agents, recent data from the Diabetic Retinopathy Clinical Research Network suggest that for eyes with CIDME and good levels of acuity, 20/40 or better, each agent effectively and similarly improves visual acuity,” the authors wrote.

Additionally, recent data have shown anti-VEGF therapy injections are more cost-effective than laser monotherapy for DME. More studies are needed to determine the cost-effectiveness of anti-VEGF injections for first-line treatment of PDR, according to the report. – by Robert Linnehan

Disclosure: Solomon reports she receives academic support through the Katharine M. Graham Professorship at Wilmer Eye Institute, Johns Hopkins School of Medicine. Please see the study for all other authors’ relevant financial disclosures.