July 02, 2014
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Top 5 retinopathy news items from the American Diabetes Association meeting

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The American Diabetes Association meeting in San Francisco included clinically relevant presentations on diabetic retinopathy as it relates to both the ophthalmic and endocrinologic medical community.

Ocular Surgery News was there to cover the late-breaking poster sessions, oral presentations and symposia on promising new screening tools and preliminary data in clinical diabetic retinopathy news.

1. Aflibercept efficacious for DME compared with laser

David Brown, MD, discussed key takeaways from a phase 3 study comparing aflibercept with laser for the treatment of diabetic macular edema.

“The subgroup randomized to laser overall did terrible. However, if the HbA1c was well controlled, they actually saw some benefit from focal laser, whereas those in the worst quartile of HbA1c saw no benefit from focal laser. This gives us hope that management of diabetes may improve outcomes with both entities in that you may be able to put off shots in the eyes top maintain visual acuity if you can maintain hba1c,” Brown told Ocular Surgery News. Watch the video.

2. Data lack support for retinal exams in youth with diabetes

Evidence does not support routine retinal screenings of pediatric patients with type 1 diabetes based solely on age and diabetes duration, according to a speaker here.

“It just so happens that retinopathy was a primary outcome in the [Diabetes Control and Complications Trial],” William V. Tamborlane, MD, said. “There were two separate cohorts: the primary prevention cohort addressed the question of whether intensive therapy prevents the development of retinopathy compared with conventional therapy in patients with relatively short duration who had no retinopathy. The secondary intervention cohort addressed the question of whether intensive therapy could alter the progression of retinopathy.” Read more.

3. RETeval device a viable option for diabetic retinopathy screening

Preliminary data indicated that the RETeval machine was easy to use, with no patient dilation or skin preparation required, and was user-friendly, requiring minimal training.

“These data are clinically relevant for ophthalmologists and endocrinologists for the treatment of diabetic retinopathy because the RETeval machine is a new tool for screening patients with diabetes for eye disease that can be performed by the primary care physician,” April Y. Maa, MD, told Ocular Surgery News. “It does not use photographs (ie, the device is not a camera), which traditionally have a failure rate of 10% to 15%, and instead measures and uses electrical signals generated by the eye (30 Hz ERG), to determine level of retinopathy.” Read more.

4. Singulair useful as diabetic retinopathy therapy

Marcella Luercio, MD, and colleagues assessed leukotriene B4 receptor 1 levels, leukotriene B4 generation, and superoxide production and effects on endothelial cells.

Data indicated that patients with diabetes demonstrated a 1.4-fold increase in B4 receptor 1 levels (P = .002), with levels increasing among patients with worsened glycemia and longer diabetes duration compared with patients without diabetes.

“If we could use this already U.S. Food and Drug Administration-approved drug to block our leukotriene pathway, it would be a great way to intervene and actually help prevent diabetic retinopathy,” Luercio said during a presentation. Read more.

5. Ultra-widefield imaging improved diabetic retinopathy detection

Ultra-widefield imaging with or without fluorescein angiography could have significant implications for identifying and treating diabetic retinopathy, according to one researcher.

“Ultra-widefield imaging with or without fluorescein angiography can help select patients for more-intensive monitoring for potentially earlier target treatments to minimize loss of visual field due to laser treatments,” Belinda A. Brooks, NP, CDE, MSc, PhD, said during a presentation here. “Ultra-widefield imaging is easier and faster to perform. It is also better-tolerated and more convenient for patients, because no mydriasis is required.” Read more.