PEER REVIEWED
Treating Diabetic Eye Disease

Along with the increase in the number of people worldwide who have type 2 diabetes, the incidence of diabetic retinopathy is on the rise, mandating that current standards of care be expanded. Diabetic macular edema (DME) is a particularly challenging related condition.

The articles on the following pages examine the current standard of care, the variations on that standard of care increasingly being used in practice, and the pharmacologic therapies that are now being evaluated in clinical trials.

Page 18: The characterization of molecular and cellular events that cause retina microvascular abnormalities in diabetic retinopathy has led to the identification of new targets for pharmacologic manipulation, e.g., vascular endothelial growth factor and protein kinase C. In addition, corticosteroids for intraocular injection and sustained-release delivery of steroids are being evaluated. This article presents results from the ongoing clinical trials of these agents and others. Authors: Rajeev Buddi, MD, and Dean Eliott, MD.

Page 24: Advances in vitreoretinal surgery, pharmacology, laser technology and imaging techniques are changing the way diabetic eye disease is being treated. New approaches, such as intravitreal steroid use, have been evaluated in uncontrolled studies but await evaluation in randomized clinical trials. This article explains the newer approaches and how they are being used -- more frequently -- in practice. Authors: Ron P. Gallemore, MD, PhD, David S. Boyer, MD, Edgar L. Thomas, MD.

Page 28: While many treatments for diabetic retinopathy are under investigation, the only treatments that have been proven effective in large-scale, randomized, controlled clinical trials are several types of laser treatment. This article reviews the recommendations from these trials, which continue to form the basis for the current management of diabetic retinopathy. Author: Abdhish Bhavsar, MD.