Addressing Treatment Dilemmas in Neovascular AMD and DME - Episode 4

Managing DME Patients Unresponsive to Anti-VEGF

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An expert retina specialist discusses challenges faced by DME patients showing suboptimal response to standard anti-VEGF treatment, emphasizing the need to reduce injection burden while preventing vision loss.

This is a video synopsis of a discussion involving Ehsan Rahimy, MD, a retina specialist at the Palo Alto Medical Foundation and adjunct faculty at Stanford University School of Medicine. Dr. Rahimy presents a case scenario of a 50-year-old African American male with poorly controlled type 2 diabetes and diabetic macular edema (DME) unresponsive to anti-vascular endothelial growth factor (VEGF) therapy.

The patient exhibits high-risk proliferative diabetic retinopathy (PDR) with visual acuities of 20/80 in the right eye and 20/200 in the left eye. Despite receiving bevacizumab and ranibizumab injections, there is no improvement in vision or central subfield thickness (CST). Dr. Rahimy emphasizes the urgency in managing this patient due to their young age and high visual acuity needs.

He discusses the shift in treatment approach towards achieving dryness earlier in the disease course, highlighting the importance of minimizing injection burden for patients. Dr. Rahimy underscores the complexity of diabetic retinopathy management and the need to optimize treatment responses while reducing the number of treatments to improve patient adherence and compliance.

The case illustrates the challenges and evolving strategies in managing DME in patients with poorly controlled diabetes, emphasizing the imperative for ophthalmologists to prioritize early and effective intervention to mitigate vision loss and enhance patient outcomes in diabetic eye disease.

Video synopsis is AI-generated and reviewed by HCPLive® editorial staff.