William W. Li
NEW ORLEANS – “In the ecosystem of diabetes care, the optometry community is on the front lines for basic, fundamental eye care,” William W. Li, MD, said at SECO.
Li is president and medical director at the Angiogenesis Foundation and a vascular medicine specialist.
“Collaboration is the take-home message,” Li said. “No single care provider can handle the entire show.”
His area of specialty is relevant to diabetic retinopathy. Angiogenesis, also known as neovascularization, is the physiological process of blood vessel growth and maintenance in all organs, from the eye, to the heart and the toes.
“It is a biological common denominator that keeps oxygen and nutrients flowing to feed living cells,” Li said.
“The difference between a harmless and deadly cancer is the formation of blood vessels that are abnormal,” he said.
Researchers are looking into how to target that growth factor, so abnormal growth can be stopped and neutralized. “It’s not too much growth or too few, it’s like Goldilocks, the right amount of blood vessel growth is important,” he said.
Li and other medical experts have explored how the optometric and ophthalmology communities can play a critical role in the complex care of patients with diabetes at the Diabetic Retinopathy Summit in January in Washington.
He shared some takeaways from that meeting:
- Blindness from diabetes is largely preventable.
- Optometrists play a critical role in diagnosing patients with diabetic retinopathy.
- A comprehensive dilated eye exam is critical and may include fundus photography and OCT to identify features that help stage diabetic retinopathy.
- Optometrists should assess the level of diabetic retinopathy and determine if the condition is approaching or in a treatable stage, in which case referral should be made to a retinal specialist for consideration of treatment.
- If the optometrist is unsure of correct staging of severity or suspects a patients is at high risk for progression, a referral should be made.
- When it comes to diabetic eye disease, there are no “bad referrals.”
At the summit they also discussed three major barriers to proper diabetes care.
When ophthalmologists and optometrists lack good communication, patients suffer, he said.
“For those of you that have good communication with your ophthalmologists, keep up the good work,” Li said.
Second, medical doctors that do not fully appreciate the front-line role of the optometrist are a barrier to proper care.
“There’s a great opportunity for optometrists to educate the medical community at large on what you guys can do,” Li added.
Third, the great thing about medicine is that the research field is changing all the time.
“Keeping up with what we are finding out is a really important thing to do,” he concluded. – by Abigail Sutton
Li, W et al. Diabetes case studies: A collaborative approach. Presented at: SECO; February 20-23, 2019; New Orleans.
Disclosure: Li is a consultant for Bayer Pharmaceuticals and president and medical director of the Angiogenesis Foundation, a 501(c)(3) nonprofit organization. His book, Eat to Beat Disease, will be released March 19.