Changing paradigms in the treatment of diabetic retinopathy

Current Opinion in Ophthalmology

Volumn 20, Issue 6, 2009, Pages 532-538

  Abu El Asrar, Ahmed M ^a   Al Mezaine, Hani S ^a   Ola, Mohammad Shamsul ^a  

^a KING SAUD UNIVERSITY   (Saudi Arabia)

Author keywords

Diabetic retinopathy; Review; Treatment

Indexed keywords

AFLIBERCEPT; BEVACIZUMAB; FIBRIC ACID DERIVATIVE; HYALURONIDASE; PEGAPTANIB; RANIBIZUMAB; RUBOXISTAURIN; TRIAMCINOLONE ACETONIDE; VASCULOTROPIN;

CLINICAL TRIAL; DIABETIC MACULAR EDEMA; DIABETIC RETINOPATHY; DRUG DOSE COMPARISON; DYSLIPIDEMIA; HUMAN; LASER COAGULATION; OPTICAL COHERENCE TOMOGRAPHY; PANCREAS ISLET TRANSPLANTATION; PRIORITY JOURNAL; REVIEW; VISUAL ACUITY; VITRECTOMY; VITREOUS HEMORRHAGE;

BLOOD PRESSURE; DIABETIC RETINOPATHY; DIET THERAPY; HUMANS; LASER COAGULATION; METABOLISM; VITRECTOMY;

EID: 74249093820     PISSN: 10408738     EISSN: None     Source Type: Journal    
DOI: 10.1097/ICU.0b013e328330b533     Document Type: Review

References (60)

1. Fong DS, Aiello L, Gardner TW, et al. Diabetic retinopathy. Diabetes Care 2003; 26 (Suppl 1):S99-S102. (Pubitemid 36934460)
2. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of longterm complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329:977-986.
3. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications trial. Arch Ophthalmol 2008; 126:1707-1715. Intensive therapy that maintains near-normal glycemic levels for an average of 6.5 years has a beneficial effect on long-term complications that extends at least 10 years beyond the actual period of such therapy. Therapy that maintains higher HbA1c levels has adverse effects on complications that persist beyond the period of high HbA1c levels.
4. Diabetes Control and Complications Trial Research Group. Early worsening of diabetic retinopathy in the Diabetes Control and Complications trial. Arch Ophthalmol 1998; 116:874-886.
5. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352:837-853.
6. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317:703-713.
7. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings. Ophthalmology 1978; 85:82-106.
8. Diabetic Retinopathy Clinical Research Network, Brucker AJ, Qin H, Antoszyk AN, et al. Observational study of the development of diabetic macular edema following panretinal (scatter) photocoagulation given in 1 or 4 sittings. Arch Ophthalmol 2009; 127:132-140. Clinically meaningful differences are unlikely in optical coherence tomography thickness or visual acuity following PRP in one sitting compared with four sittings.
9. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985; 103:1796-1806.
10. Ferris F. Early photocoagulation in patients with either type I or type II diabetes. Trans Am Ophthalmol Soc 1996; 94:503-537.
11. Writing Committee for the Diabetic Retinopathy Clinical Research Network, Fong DS, Strauber SF, Aiello LP, et al. Comparison of the modified Early Treatment Diabetic Retinopathy Study and mild macular grid laser photocoagulation strategies for diabetic macular edema. Arch Ophthalmol 2007; 125:469-480.
12. The Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Arch Ophthalmol 1985; 103:1644-1652.
13. Warnock GL, Thompson DM, Meloche RM, et al. A multiyear analysis of islet transplantation compared with intensive medical therapy on progression of complications in type 1 diabetes. Transplantation 2008; 86:1762-1766. Islet transplantation yields improved HbA1c and less progression of retinopathy compared with intensive medical therapy during 3 years of follow-up.
14. Thompson DM, Begg IS, Harris C, et al. Reduced progression of diabetic retinopathy after islet cell transplantation compared with intensive medical therapy. Transplantation 2008; 85:1400-1405.
15. Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet 2007; 370:1687-1697.
16. PKC-DRS2 Group, Aiello LP, Davis MD, Girach A, et al. Effect of ruboxistaurin on visual loss in patients with diabetic retinopathy. Ophthalmology 2006; 113:2221-2230.
17. PKC-DMES Study Group. Effect of ruboxistaurin in patients with diabetic macular edema: thirty-month results of the randomized PKC-DMES clinical trial. Arch Ophthalmol 2007; 125:318-324.
18. PKC-DRS2 Study Group, Davis MD, Sheetz MJ, Aiello LP, et al. Effect of ruboxistaurin on the visual acuity decline associated with long-standing diabetic macular edema. Invest Ophthalmol Vis Sci 2009; 50:1-4. RBX treatment may ameliorate DME-associated visual decline.
19. Cunningham ET Jr, Adamis AP, Altaweel M, et al. A phase II randomized double masked trial of pegaptanib, an antivascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology 2005; 112:1747-1757.
20. Adamis AP, Altaweel M, Bressler NM, et al. Changes in retinal neovascularization after pegaptanib (Macugen) therapy in diabetic individuals. Ophthalmology 2006; 113:23-28.
21. Chun DW, Heier JS, Topping TM, et al. A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant diabetic macular edema. Ophthalmology 2006; 113:1706-1712.
22. Nguyen QD, Tatlipinar S, Shah SM, et al. Vascular endothelial growth factor is a critical stimulus for diabetic macular edema. Am J Ophthalmol 2006; 142:961-969.
23. Do DV, Nguyen QD, Shah SM, et al. An exploratory study of the safety, tolerability and bioactivity of a single intravitreal injection of vascular endothelial growth factor Trap-Eye in patients with diabetic macular edema. Br J Ophthalmol 2009; 93:144-149.
24. Arevalo JF, Sanchez JG, Fromow-Guerra J, et al. Comparison of two doses of primary intravitreal bevacizumab (Avastin) for diffuse diabetic macular edema: results from the Pan-American Collaborative Retina Study Group (PACORES) at 12-month follow-up. Graefes Arch Clin Exp Ophthalmol 2009; 247:735-743.
25. Diabetic Retinopathy Clinical Research Network, Scott IU, Edwards AR, Beck RW, et al. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology 2007; 114:1860-1867.
26. Kook D, Wolf A, Kreutzer T, et al. Long-term effect of intravitreal bevacizumab (Avastin) in patients with chronic diffuse diabetic macular edema. Retina 2008; 28:1053-1060.
27. Roh MI, Byeon SH, Kwon OW. Repeated intravitreal injection of bevacizumab for clinically significant diabetic macular edema. Retina 2008; 28:1314-1318.
28. Fang X, Sakaguchi H, Gomi F, et al. Efficacy and safety of one intravitreal injection of bavacizumab in diabetic macular edema. Acta Ophthalmol 2008; 86:800-805.
29. Paccola L, Costa RA, Folgosa MS, et al. Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study). Br J Ophthalmol 2008; 92:76-80.
30. Yanyali A, Aytug B, Horozoglu F, Nohutcu AF. Bevacizumab (Avastin) for diabetic macular edema in previously vitrectomized eyes. Am J Ophthalmol 2007; 144:124-126.
31. Arevalo JF, Wu L, Sanchez JG, et al. Intravitreal bevacizumab (Avastin) for proliferative diabetic retinopathy: 6-months follow-up. Eye 2009; 23:117-123.
32. Jiang Y, Liang X, Li X, et al. Analysis of the clinical efficacy of intravitreal bevacizumab in the treatment of iris neovascularization caused by proliferative diabetic retinopathy. Acta Ophthalmol 2008. [Epub ahead of print]
33. Beutel J, Peters S, Lüke M, et al. Bevacizumab as adjuvant for neovascular glaucoma. Acta Ophthalmol 2008. [Epub ahead of print]
34. Wakabayashi T, Oshima Y, Sakaguchi H, et al. Intravitreal bevacizumab to treat iris neovascularization and neovascular glaucoma secondary to ischemic retinal diseases in 41 consecutive cases. Ophthalmology 2008; 115:1571-1580.
35. Mason JO III, Yunker JJ, Vail R, McGwin G Jr. Intravitreal bevacizumab (Avastin) prevention of panretinal photocoagulation-induced complications in patients with severe proliferative diabetic retinopathy. Retina 2008; 28:1319-1324. A single intravitreal injection of bevacizumab before standard PRP may be beneficial in preventing PRP-induced visual dysfunction and foveal thickening in eyes with severe PDR and good vision.
36. Tonello M, Costa RA, Almeida FP, et al. Panretinal photocoagulation versus PRP plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy (BeHi study). Acta Ophthalmol 2008; 86:385-389. The adjunctive use of IVB with PRP was associated with a greater reduction in the area of active leaking new vessels than PRP alone in patients with high-risk PDR.
37. Cho WB, Oh SB, Moon JW, Kim HC. Panretinal photocoagulation combined with intravitreal bevacizumab in high-risk proliferative diabetic retinopathy. Retina 2009; 29:516-522. IVB before PRP can be an effective adjunctive treatment to PRP in the treatment of high-risk PDR.
38. Yang CM, Yeh PT, Yang CH, Chen MS. Bevacizumab pretreatment and longacting gas infusion on vitreous clear-up after diabetic vitrectomy. Am J Ophthalmol 2008; 146:211-217. IVB pretreatment combined with C3F8 10% infusion could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up for eyes with active PDR.
39. Rizzo S, Genovesi-Ebert F, Di Bartolo E, et al. Injection of intravitreal bevacizumab (Avastin) as a preoperative adjunct before vitrectomy surgery in the treatment of severe proliferative diabetic retinopathy (PDR). Graefes Arch Clin Exp Ophthalmol 2008; 246:837-842. IVB administered prior to vitrectomy reduced active neovascularization, thus facilitating pars plana vitrectomy.
40. Arevalo JF, Maia M, Flynn HW Jr, et al. Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol 2008; 92:213-216. Tractional retinal detachment may occur or progress shortly following administration of IVB in patients with severe PDR.
41. Massin P, Audren F, Haochine B, et al. Intravitreal triamcinolone acetonide for diabetic diffuse macular edema: preliminary results of a prospective controlled trial. Ophthalmology 2004; 111:218-224.
42. Kang SW, Sa HS, Cho HY, Kim JI. Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema. Arch Ophthalmol 2006; 124:653-658.
43. Beer PM, Bakri SJ, Singh RJ, et al. Intraocular concentration and pharmacokinetics of triamcinolone acetonide after a single intravitreal injection. Ophthalmology 2003; 110:681-686.
44. Gillies MC, Sutter FK, Simpson JM, et al. Intravitreal triamcinolone for refractory diabetic macular edema: two-year results of a double-masked, placebo-controlled, randomized clinical trial. Ophthalmology 2006; 113:1533-1538.
45. Diabetic Retinopathy Clinical Research Network. A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology 2008; 115:1447-1459. Over a 2-year period, focal/grid photocoagulation is more effective and has fewer side effects than 1-mg or 4-mg doses of preservative-free intravitreal triamcinolone for patients with DME.
46. Diabetic Retinopathy Clinical Research Network (DRCR.net), Beck RW, Edwards AR, Aiello LP, et al. Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema. Arch Ophthalmol 2009; 127:245-251. The 3-year visual outcome results are consistent with the 2-year results. Most eyes receiving 4mg of intravitreal triamcinolone are likely to require cataract surgery.
47. Lam DS, Chan CK, Mohamed S, et al. Intravitreal triamcinolone plus sequential grid laser versus triamcinolone or laser alone for treating diabetic macular edema: six-month outcomes. Ophthalmology 2007; 114:2162-2167.
48. Maia OO Jr, Takahashi BS, Costa RA, et al. Combined laser and intravitreal triamcinolone for proliferative diabetic retinopathy and macular edema: oneyear results of a randomized clinical trial. Am J Ophthalmol 2009; 147:291-297. The combination of laser photocoagulation with intravitreal triamcinolone was associated with improved best corrected visual acuity and decreased central macular thickness and total macular volume when compared with laser photocoagulation alone for the treatment of PDR with clinically significant macular edema.
49. Shimura M, Nakazawa T, Yasuda K, et al. Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema. Am J Ophthalmol 2008; 145:854-861.
50. Stolba U, Binder S, Gruber D, et al. Vitrectomy for persistent diffuse diabetic macular edema. Am J Ophthalmol 2005; 140:295-301.
51. Recchia FM, Ruby AJ, Carvalho Recchia CA. Pars plana vitrectomy with removal of the internal limiting membrane in the treatment of persistent diabetic macular edema. Am J Ophthalmol 2005; 139:447-454.
52. Kumagai K, Furukawa M, Ogino N, et al. Long-term follow-up of vitrectomy for diffuse nontractional diabetic macular edema. Retina 2009; 29:464-472. Pars plana vitrectomy with and without internal limiting membrane peeling appears to be beneficial in eyes with diffuse nontractional DME and its effectiveness is maintained long-term.
53. Yamamoto T, Takeuchi S, Sato Y, Yamashita H. Long-term follow-up results of pars plana vitrectomy for diabetic macular edema. Jpn J Ophthalmol 2007; 51:285-291.
54. Massin P, Duguid G, Erginay A, et al. Optical coherence tomography for evaluating diabetic macular edema before and after vitrectomy. Am J Ophthalmol 2003; 135:169-177.
55. Thomas D, Bunce C, Moorman C, Laidlaw DA. A randomised controlled feasibility trial of vitrectomy versus laser for diabetic macular oedema. Br J Ophthalmol 2005; 89:81-86.
56. Shah SP, Patel M, Thomas D, et al. Factors predicting outcome of vitrectomy for diabetic macular oedema: results of a prospective study. Br J Ophthalmol 2006; 90:33-36.
57. Figueroa M, Contreras I, Noval S. Surgical and anatomical outcomes of pars plana vitrectomy for diffuse nontractional diabetic macular edema. Retina 2008; 28:420-426. In diffuse DME with no retinal traction, vitrectomy produces a short-term improvement in retinal thickness but no long-term anatomical or functional improvements.
58. Patel JI, Hykin PG, Schadt M, et al. Pars plana vitrectomy with and without peeling of the inner limiting membrane for diabetic macular edema. Retina 2006; 26:5-13.
59. Yamamoto T, Hitani K, Sato Y, et al. Vitrectomy for diabetic macular edema with and without internal limiting membrane removal. Ophthalmologica 2005; 219:206-213. (Pubitemid 41160189)
60. Kuppermann BD, Thomas EL, de Smet MD, et al., Vitrase for Vitreous Hemorrhage Study Group. Pooled efficacy results from two multinational randomized controlled clinical trials of a single intravitreous injection of highly purified ovine hyaluronidase (Vitrase) for the management of vitreous hemorrhage. Am J Ophthalmol 2005; 140:573-584.