Anti-VEGF treatment in diabetic macular edema
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Published:
Sep 30, 2015
Keywords:
diabetes, diabetic macular edema, anti-VEGF therapy, VEGF inhibitors, laser photocoagulation, ranibizumab, afilbercept, combined therapy
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Abstract
Macular edema is the leading cause of considerable visual impairment in diabetic patients. Elevated levels of vascular endothelial growth factor (VEGF) in the vitreous humour play a key role in accumulation of fluid and in formation of diabetic macular edema. According to the results of multiple studies, anti-VEGF therapy with ranibizumab, bevacizumab or aflibercept proved to be more effective in improving vision in patients with decreased visual acuity due to diabetic macular edema (both in mono- and combined therapy) than laser photocoagulation. The paper presents different treatment options of anti- VEGF therapy depending on various forms of macular edema, visual acuity and previously undergone treatments to achieve the best functional results in an individual patient.
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Mozolewska-Piotrowska K. Anti-VEGF treatment in diabetic macular edema. Ophthatherapy [Internet]. 2015Sep.30 [cited 2024Jul.3];2(3):205-10. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/643
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References
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12. Do DV, Schmidt-Erfurth U, Gonzalez VH et al. The DA VINCI Study: phase II primary results of VEGF Trap-Eye in patients with diabetic macular edema. Ophthalmology. 2011; 118(9): 1819-1826.
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14. Arevalo JF, Fromow-Guerra J, Quiriz-Mercado H et al.; The Pan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow up. Ophthalmology. 2007; 114: 743-50.
15. Michaelides M, Kaines A, Hamilton RD et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT Study) 12-month data: report 2. Ophthalmology. 2010; 117: 1107-18.
16. Wells JA, Glassman AR, Jampol LM et al.; Diabetic Retinopathy Clinical Research Network. Aflibercept, bevacizumab or ranibizumab for diabetic macular edema. N Engl J Med. 2015; 372: 1193-203.
17. Bandello F, De Benedetto U, Knutsson KA et al. Ranibizumab in the treatment of patients with visual impairment due to diabetic macular edema. Clin Ophthalmol. 2011; 5: 1303-8.
18. Elman MJ, Bressler NM, Qin H et al.; Diabetic Retinopathy Clinical Research Network. Expanded 2 year follow up of ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2011; 118: 609-14.
19. Nguyen QD, Shah SM, Khwaja AA et al. Two year outcomes of the ranibizumab for edema of the macula in diabetes (READ-2) study. Ophthalmology. 2007; 114: 1860-7.
20. Googe J, Brucker AJ, Bressler NM et al. Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina. 2011; 31: 1009-27.
21. Sohn HJ, Han DH, Kim TI et al. Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema. Am J Ophthalmol. 2011; 152: 686-94.
22. Soheilian M, Ramezani A, Obudi A et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology. 2009; 116: 1142-50.
23. Synek S, Vojnikovic B. Intravitreal bevacizumab with or without triamcinolone for refractory diabetic macular edema. Coll Antropol. 2010; 34(2): 99-103.
24. Cunha-Vaz J, Ashton P, Lezzi R et al. Sustained delivery fluocinolone acetonide vitreous implants: long term benefit in patients with chronic diabetic macular edema. Ophthalmology. 2014; 121: 1892-903.
25. Stewart MW. Corticosteroid use for diabetic macular edema: old fad or a new trend? Curr Diab Rep. 2012; 12: 364-75.
2. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. British Medical Journal. 1998; 317: 703-13.
3. Arend O, Remky A, Elsner AE et al. Quantification of cystoid changes in diabetic maculopathy. Invest Ophthalmol Vis Sci. 1995; 36(3): 608-13.
4. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: early treatment diabetic retinopathy study report number 1. Archives of Ophthalmology. 1985; 103(12): 1796-806.
5. Nguyen QD, Tatlipinar S, Shah SM et al. Vascular endothelial growth factor is a critical stimulus for diabetic macular oedema. Am J Ophthalmol. 2006; 142: 961-9.
6. Aiello LP, Avery RL, Arrigg PG et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994; 331: 1480-7.
7. Funatsu H, Yamashita H, Sakata K et al. Vitreous levels of vascular endothelial growth factor and intercellular adhesion molecule 1 are related to diabetic macular edema. Ophthalmology. 2005; 112: 806-16.
8. Massin P, Bandello F, Garweg JG et al. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE study): a 12-month randomized, controlled, double masked, multiceter phase II study. Diabetes Care. 2010; 33: 2399-405.
9. Mitchell P, Bandello F, Schmidt-Erfurth U et al. The RESTORE Study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011; 118: 615-25.
10. Brown DM, Nguyen QD, Marcus DM et al.; RIDE and RISE Research Group. Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE. Ophthalmology. 2013; 120: 2013-22.
11. Campochiaro PA, Wykoff CC, Shapiro H et al. Neutralization of vascular endothelial growth factor slows progression of retinal nonperfusion in patients with diabetic macular edema. Ophthalmology. 2014; 121: 1783-9.
12. Do DV, Schmidt-Erfurth U, Gonzalez VH et al. The DA VINCI Study: phase II primary results of VEGF Trap-Eye in patients with diabetic macular edema. Ophthalmology. 2011; 118(9): 1819-1826.
13. Korobelnik JF, Do DV, Schmidt-Erfurth U et al. Intravitreal aflibercept for diabetic macular edema. Ophthalmology. 2014; 121: 2247-54.
14. Arevalo JF, Fromow-Guerra J, Quiriz-Mercado H et al.; The Pan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow up. Ophthalmology. 2007; 114: 743-50.
15. Michaelides M, Kaines A, Hamilton RD et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT Study) 12-month data: report 2. Ophthalmology. 2010; 117: 1107-18.
16. Wells JA, Glassman AR, Jampol LM et al.; Diabetic Retinopathy Clinical Research Network. Aflibercept, bevacizumab or ranibizumab for diabetic macular edema. N Engl J Med. 2015; 372: 1193-203.
17. Bandello F, De Benedetto U, Knutsson KA et al. Ranibizumab in the treatment of patients with visual impairment due to diabetic macular edema. Clin Ophthalmol. 2011; 5: 1303-8.
18. Elman MJ, Bressler NM, Qin H et al.; Diabetic Retinopathy Clinical Research Network. Expanded 2 year follow up of ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2011; 118: 609-14.
19. Nguyen QD, Shah SM, Khwaja AA et al. Two year outcomes of the ranibizumab for edema of the macula in diabetes (READ-2) study. Ophthalmology. 2007; 114: 1860-7.
20. Googe J, Brucker AJ, Bressler NM et al. Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina. 2011; 31: 1009-27.
21. Sohn HJ, Han DH, Kim TI et al. Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema. Am J Ophthalmol. 2011; 152: 686-94.
22. Soheilian M, Ramezani A, Obudi A et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology. 2009; 116: 1142-50.
23. Synek S, Vojnikovic B. Intravitreal bevacizumab with or without triamcinolone for refractory diabetic macular edema. Coll Antropol. 2010; 34(2): 99-103.
24. Cunha-Vaz J, Ashton P, Lezzi R et al. Sustained delivery fluocinolone acetonide vitreous implants: long term benefit in patients with chronic diabetic macular edema. Ophthalmology. 2014; 121: 1892-903.
25. Stewart MW. Corticosteroid use for diabetic macular edema: old fad or a new trend? Curr Diab Rep. 2012; 12: 364-75.