Emerging clinical evidence of a dual role for Ang-2 and VEGF-A blockade with faricimab in retinal diseases.

Anti-vascular endothelial growth factor (VEGF) therapies have transformed the treatment of retinal diseases. However, VEGF signaling is only one component of the complex, multifactorial pathophysiology of retinal diseases, and many patients have residual disease activity despite ongoing anti-VEGF treatment. The angiopoietin/tyrosine kinase with immunoglobulin and epidermal growth factor receptor-2 (Ang/Tie2) signaling pathway is critical to endothelial cell homeostasis, survival, integrity, and vascular stability.

Phase 1b Dose Escalation Study of Sozinibercept Inhibition of Vascular Endothelial Growth Factors C and D With Aflibercept for Diabetic Macular Edema.

Purpose: Sozinibercept inhibits vascular endothelial growth factors (VEGFs) C and D. This study evaluated outcomes following switching from anti-VEGF-A monotherapy to intravitreal injections of three dose levels of sozinibercept in combination with aflibercept in patients with diabetic macular edema (DME).

Methods: A phase 1b, open-label, multicenter dose-escalation study with a 24-week follow-up.

Deciphering the role of exosomal derived regulatory noncoding RNAs as potential biomarkers for diabetic retinopathy: a systematic review.

About one-third of individuals with diabetes develop diabetic retinopathy (DR), with one-tenth experiencing vision-threatening conditions such as diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). Current treatments only show recovery in 50% of cases, and the disease often remains asymptomatic. Therefore, novel early detection methods and new biomarkers are crucial.

[MiHUBx: a digital progress hub for the use of intersectoral clinical data sets using the example of diabetic macular edema].

Background: Evidence-based treatment recommendations are helpful in the corresponding discipline-specific treatment but can hardly take data from real-world care into account. In order to make better use of this in everyday clinical practice, including with respect to predictive statements about disease development or treatment success, models with data from treatment must be developed in order to use them for the development of assistive artificial intelligence.

Goal: The aim of the Use Case 1 of the medical informatics hub in Saxony (MiHUBx) is the development of a model based on treatment and research data for a treatment algorithm supported by biomarkers and also the development of the necessary digital infrastructure.

Molecular-Genetic Biomarkers of Diabetic Macular Edema.

Diabetic macular edema (DME) is a leading cause of vision impairment and blindness among diabetic patients, requiring effective diagnostic and monitoring strategies. This systematic review aims to synthesize current knowledge on molecular biomarkers associated with DME, focusing on their potential to improve diagnostic accuracy and disease management. A comprehensive search was conducted in PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials, covering literature from 2004 to 2023.

Real-World Outcomes of Different Types of Treatment for Diabetic Macular Edema Before and After Approval of Anti-Vascular Endothelium Growth Factor Agents.

: The object of this study was to determine the outcomes of treatments other than anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME) before and after the approval of anti-VEGF therapy in Japan. : This was a retrospective study registered in the database of the Survey of Treatment for DME (STREAT-DME). A total of 1683 patients treated from 2010 to 2017 were included.

Intraoperative OCT-Guided Selective Epiretinal Membrane (ERM) Peeling Versus ERM and Internal Limiting Membrane Peeling for Tractional Macular Edema in Diabetic Eyes.

Background And Aim: Despite the abundant literature, internal limiting membrane (ILM) peeling remains a controversial topic, especially in diabetic eyes. We compared the safety and effectiveness of intraoperative optical coherence tomography (iOCT)-assisted selective epiretinal membrane (ERM) peeling with dye-assisted ERM and ILM peeling, for the treatment of tractional diabetic macular edema (tDME).

Material And Methods: In this single-center retrospective study, we evaluated consecutive patients with tDME who underwent iOCT-assisted selective ERM peeling (Group A) or "dual blue" dye-assisted ERM and ILM peeling (Group B).

Clinically Meaningful Change Estimates for the National Eye Institute Visual Function Questionnaire-25 in Patients With Diabetic Macular Edema.

Purpose: To derive estimates of clinically meaningful change (improvement) on the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with diabetic macular edema (DME) using anchor- and distribution-based methods.

Methods: In this exploratory post hoc analysis of data from the RIDE/RISE (NCT00473382/NCT00473330) clinical trials of ranibizumab for DME, the NEI VFQ-25 was completed at baseline and six, 12, 18, and 24 months. Anchor-based (≥5-, ≥10-, and ≥15-letter gain in best-corrected visual acuity [BCVA]) and distribution-based estimates were calculated.

Enhancing diabetic retinopathy and macular edema detection through multi scale feature fusion using deep learning model.

Background: This work tackles the growing problem of early identification of diabetic retinopathy and diabetic macular edema. The deep neural network design utilizes multi-scale feature fusion to improve automated diagnostic accuracy. Methods This approach uses convolutional neural networks (CNN) and is designed to combine higher-level semantic inputs with low-level textural characteristics.

Semi-supervised 3D retinal fluid segmentation via correlation mutual learning with global reasoning attention.

Accurate 3D segmentation of fluid lesions in optical coherence tomography (OCT) is crucial for the early diagnosis of diabetic macular edema (DME). However, higher-dimensional spatial complexity and limited annotated data present significant challenges for effective 3D lesion segmentation. To address these issues, we propose a novel semi-supervised strategy using a correlation mutual learning framework for segmenting 3D DME lesions from 3D OCT images.

Predictors of Vision Loss After Lapse in Antivascular Endothelial Growth Factor Treatment in Patients With Diabetic Macular Edema.

To identify baseline characteristics that predict visual outcomes after a lapse in treatment among patients with diabetic macular edema (DME) who received intravitreal antivascular endothelial growth factor injections. In this retrospective study, patients with DME who had lapses in treatment of 3 months or longer were separated into 2 groups (stable vision, n = 201; vision loss, n = 61) based on an Early Treatment Diabetic Retinopathy Study vision loss threshold of 10 letters. Stepwise backward logistic regression was used to analyze baseline factors associated with vision loss and to create a predictive algorithm.

Evolution of Workload Associated with Anti-VEGF Treatments for AMD, DME, RVO and mCNV in Hospital District of Southwest Finland.

Background: The prevalence of vision-threatening diseases, such as age-related macular degeneration (AMD) and diabetic macular edema (DME), is likely to increase in developed countries owing to an aging population, rising life expectancy, and unfavorable lifestyle changes. Increases in the burden of vision-threatening diseases pose a challenge to the healthcare system. After the emergence of intravitreal anti-VEGF inhibitors, treatment options for neovascular AMD (nAMD), DME, retinal vein occlusion (RVO) and myopic choroidal neovascularization (myopic CNV) have increased.

Brolucizumab versus Aflibercept in Patients with Diabetic Macular Edema: A Meta-Analysis of Randomized Controlled Trials.

Purpose: To assess efficacy and safety of brolucizumab versus aflibercept in patients with diabetic macular edema (DME).

Patients And Methods: We performed a systematic review and meta-analysis with trial sequential analysis (TSA). We searched Embase, Cochrane Central Register of Controlled Trials and PubMed databases from inception to February 16, 2024 for randomized controlled trials (RCTs) comparing brolucizumab with aflibercept in patients with DME and reporting any of the visual, anatomical and safety outcomes of interest.

Improving Clinical Management of Diabetic Macular Edema: Insights from a Global Survey of Patients, Healthcare Providers, and Clinic Staff.

Introduction: In contrast with patients receiving therapy for retinal disease during clinical trials, those treated in routine clinical practice experience various challenges (including administrative, clinic, social, and patient-related factors) that can often result in high patient and clinic burden, and contribute to suboptimal visual outcomes. The objective of this study was to understand the challenges associated with clinical management of diabetic macular edema from the perspectives of patients, healthcare providers, and clinic staff, and identify opportunities to improve eye care for people with diabetes.

Methods: We conducted a survey of patients with diabetic macular edema, providers, and clinic staff in 78 clinics across 24 countries on six continents, representing a diverse range of individuals, healthcare systems, settings, and reimbursement models.

Multiple gene therapy as a tool for regulating the expression of molecules involved in neovascular age-related macular degeneration.

Anti-vascular endothelial growth factor (VEGF) therapies have revolutionized the treatment of neovascular age-related macular degeneration (nAMD) and other retinal diseases. However, the necessity for repeated intravitreal injections and the observation of variable treatment responses calls for new treatment modalities where fewer and more effective interventions can result in a clinical effect. Gene therapy might be such an alternative, and therefore the development and clinical application of gene therapy aimed at modifying gene expression has received considerable attention.

Multi-Omics Integration With Machine Learning Identified Early Diabetic Retinopathy, Diabetic Macula Edema and Anti-VEGF Treatment Response.

Purpose: Identify optimal metabolic features and pathways across diabetic retinopathy (DR) stages, develop risk models to differentiate diabetic macular edema (DME), and predict anti-vascular endothelial growth factor (anti-VEGF) therapy response.

Methods: We analyzed 108 aqueous humor samples from 78 type 2 diabetes mellitus patients and 30 healthy controls. Ultra-high-performance liquid chromatography-high-resolution-mass-spectrometry detected lipidomics and metabolomics profiles.

Automated Detection of Central Retinal Artery Occlusion Using OCT Imaging via Explainable Deep Learning.

Objective: To demonstrate the capability of a deep learning model to detect central retinal artery occlusion (CRAO), a retinal pathology with significant clinical urgency, using OCT data.

Design: Retrospective, external validation study analyzing OCT and clinical baseline data of 2 institutions via deep learning classification analysis.

Subjects: Patients presenting to the University Medical Center Tübingen and the University Medical Center Hamburg-Eppendorf in Germany.

Prevalence of Diabetic Retinopathy Among Native Americans with Diabetes at a Tribal Clinic in Oklahoma.

Purpose: Native Americans (NAs) have the highest prevalence of diabetes mellitus (DM) of any racial group in the USA and are therefore at higher risk for diabetic retinopathy (DR) and diabetic macular edema (DME). This study estimated the prevalence of DR and DME among NAs receiving eye exams at the Citizen Potawatomi Nation (CPN) clinic, a tribal clinic in Oklahoma serving members of multiple tribes, and characterized risk markers associated with the presence and severity of DR.

Methods: A retrospective chart review identified tribal members with DM who received dilated retinal fundus exams at the CPN clinic between 2021 and 2023.

Evaluating the efficacy of AI systems in diabetic retinopathy detection: A comparative analysis of Mona DR and IDx-DR.

Purpose: To compare two artificial intelligence (AI)-based Automated Diabetic Retinopathy Image Assessment (ARIA) softwares in terms of concordance with specialist human graders and referable diabetic retinopathy (DR) diagnostic capacity.

Methods: Retrospective comparative study including 750 consecutive diabetes mellitus patients imaged for non-mydriatic fundus photographs. For each patient four images (45 degrees field of view) were captured, centered on the optic disc and macula.

Clopidogrel therapy in nonischemic central retinal vein occlusion: A case report and therapeutic insight.

Central retinal vein occlusion (CRVO) is a significant cause of vision impairment in adults, often associated with various systemic and ocular risk factors. The current literature presents a limited understanding of the efficacy of antithrombotic agents in CRVO management, with sparse comparative studies evaluating the effectiveness of different antiplatelet therapies. Here, we report the case of nonischemic CRVO in a 54-year-old male with multiple systemic comorbidities, including diabetes mellitus, hypertension, and dyslipidemia.

Comparison of one-year real-world outcomes between red (670 nm) subthreshold micropulse laser treatment and intravitreal aflibercept injection for treatment-naïve diabetic macular edema.

Purpose: To evaluate the treatment outcomes of subthreshold micropulse laser (SMPL) with a wavelength of 670 nm (red) for treatment-naïve diabetic macular edema (DME).

Methods: A retrospective observational study which included 42 eyes in 34 patients diagnosed with treatment-naïve DME was conducted. Twenty-one eyes underwent red SMPL and the other 21 eyes underwent intravitreal injection of aflibercept (IVA) as initial treatment and were followed up for 12 months.

Influence of Common Medications on Diabetic Macular Edema in Type 2 Diabetes Mellitus.

Purpose: This study aimed to assess the impact of systemic medications, including GLP-1 receptor agonists (GLP-1 RAs), fenofibrates, thiazolidinediones (TZDs), and calcium channel blockers (CCBs), on the risk of developing diabetic macular edema (DME) in patients with type 2 diabetes mellitus (T2DM).

Design: A retrospective cohort study was conducted using electronic medical records (EMR) data from the TriNetX health research network, covering a period from October 2004-2024.

Participants: The study population comprised patients diagnosed with T2DM who were newly initiated on GLP-1 RAs, fenofibrates, TZDs, or CCBs.