Suprachoroidal triamcinolone acetonide (CLS-TA, Clearside Biomedical) injection resulted in visual and anatomic improvements in eyes with diabetic macular edema, particularly in those that were treatment-naïve. Multiple injections of the investigational treatment were well-tolerated and associated with a low incidence of IOP elevation.
Quantitative assessment of retinovascular features on ultra-widefield angiography images showed significant improvements in leakage and ischemia following treatment with aflibercept in patients with diabetic macular edema and retinal vein occlusion.
Development of technologies for sustained drug delivery is a topic of great interest among retina specialists considering the number of chronic conditions that are managed with repeated intravitreal injections.
The fluocinolone acetonide 0.2 mcg/day implant (Iluvien, Alimera Sciences) offers an additional option for treating diabetic macular edema that reduces the need for subsequent therapy with anti-vascular endothelial growth factor or steroid treatment.
The visual outcomes after anti-VEGF therapy administered to treat diabetic macular edema in the “real world” do not achieve those reported in randomized clinical trials. Eyes with better baseline visual acuity are disproportionately affected.
ALG-1001 is an integrin receptor inhibitor that acts to stabilize the retina’s response to diabetes-related hypoxic and oxidative stress, mitigating production of a host of molecules involved in the development of diabetic macular edema.
Patients with diabetic retinopathy have a high risk of developing macular edema after cataract surgery. Intravitreal injections of aflibercept might result in fewer patients developing macular edema in this patient population.
ALG-1001 (Luminate, Allegro Ophthalmics) has a number of different mechanisms of action that benefit patients chronically treated with anti-vascular endothelial growth factor drugs and those who are treatment naïve.
A better understanding of the pathophysiologic mechanisms of diabetes has resulted in improved control of its local and systemic comorbidities. Further developments are needed, however, considering the growing number of diabetic patients and who are at risk for late-stage diabetic eye disease.