Advances in the treatment of diabetic retinopathy

As the diabetes epidemic in the United States continues to worsen, so too does the prevalence of diabetic retinopathy (DR). DR is divided broadly into nonproliferative and proliferative stages, with or without vision-threatening macular edema. Progression to proliferative DR is associated with visio...

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Podrobná bibliografia
Vydané v:	Journal of diabetes and its complications Ročník 33; číslo 12; s. 107417
Hlavní autori:	Singh, Rishi P., Elman, Michael J., Singh, Simran K., Fung, Anne E., Stoilov, Ivaylo
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Elsevier Inc 01.12.2019 Elsevier Limited
Predmet:	Angiogenesis Inhibitors - administration & dosage Angiogenesis Inhibitors - adverse effects Anti-VEGF therapy Clinical medicine Clinical trials Clinical Trials, Phase III as Topic - methods Clinical Trials, Phase III as Topic - statistics & numerical data Collaboration Diabetes Diabetic macular edema Diabetic retinopathy Diabetic Retinopathy - drug therapy Diabetic Retinopathy - epidemiology Disease Progression Edema Endocrinology - methods Endocrinology - trends FDA approval Hispanic Americans Humans Immunotherapy Intravitreal Injections Lasers Macular Edema - drug therapy Macular Edema - epidemiology Macular Edema - etiology Medical personnel Mental health Monoclonal antibodies Ophthalmology - methods Ophthalmology - trends Patients Quality of life Quality standards Ranibizumab Ranibizumab - administration & dosage Ranibizumab - adverse effects Receptors, Vascular Endothelial Growth Factor - administration & dosage Recombinant Fusion Proteins - administration & dosage Recombinant Fusion Proteins - adverse effects Severity of Illness Index Vascular endothelial growth factor Vascular endothelial growth factor A Visual Acuity United States > US Diabetic retinopathy Vascular endothelial growth factor A Anti-VEGF therapy Diabetic macular edema Ranibizumab
ISSN:	1056-8727, 1873-460X, 1873-460X
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Popis
Shrnutí:	As the diabetes epidemic in the United States continues to worsen, so too does the prevalence of diabetic retinopathy (DR). DR is divided broadly into nonproliferative and proliferative stages, with or without vision-threatening macular edema. Progression to proliferative DR is associated with vision loss that is often irreparable, and a rapid decline in health-related quality of life. Vascular endothelial growth factor (VEGF)-A is upregulated in the diabetic eye, and has been identified as a key driver of DR pathogenesis. With this perspective, we review the published phase III clinical trial data of anti-VEGF therapies approved for the treatment of DR in the United States. Using the Early Treatment Diabetic Retinopathy Study Diabetic Retinopathy Severity Scale, in which an improvement of ≥2 steps is considered clinically significant, approximately one-third of patients with DR and macular edema experience this level of improvement after 1 year of treatment with either ranibizumab or aflibercept. The rates of clinically significant DR improvement with ranibizumab could be twice that in the subgroup of patients with moderately severe or severe nonproliferative DR and macular edema. These clinical trial data indicate that intraocular inhibition of VEGF is a rational approach for the management of DR.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	1056-8727 1873-460X 1873-460X
DOI:	10.1016/j.jdiacomp.2019.107417