DIABETIC EYE DISEASE: COLLABORATION BETWEEN OPTOMETRISTS AND RETINA SPECIALISTS

February 26, 2021

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EPISODE 1: Current Landscape and Unmet Needs

A discussion on the current landscape and unmet needs in the management of diabetic retinopathy and diabetic macular edema, focusing on the goals of effective care in patients with diabetic retinal disease - what currently works in practice and what can be improved.


EPISODE 2: Shifting the Paradigm in Management

With the progressive nature of diabetic retinal disease and its potential for vision –threatening damage, management of the disease can be multi-faceted. This discussion revolves around how the paradigm in management can be shifted to establish that successful treatment also includes early identification of disease process, appropriate timing of referral, and improved provider and patient awareness.


EPISODE 3: Advances in the Treatment of DME and DR

The advent of treatment modalities for DR and DME has raised some questions on what these advances mean for patients in practice. Using existing data and their own experiences, an optometrist and a retina specialist look at anti-VEGF therapy within clinical practice – the appropriate patient types, its use with other modalities – and its role as the standard of care in diabetic retinal disease.


EPISODE 4: Evolving Partnership and Collaboration in Diabetic Eye Disease

In the concluding discussion to the series, the round table provides a summary of the previous episodes, with a focus on early intervention, patient communication, and collaboration between optometrists and retina specialists in the treatment of diabetic retinopathy and diabetic macular edema.


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Presenters

A. Paul Chous, MA, OD, FAAO
Optometrist, Author, Diabetes Eye Care and Education Specialist Washington State
Adjunct Professor, Western University of Health Sciences Pomona, CA

W. Lloyd Clark, MD
Ophthalmologist at Palmetto Retina Center LLC in West Columbia, SC
Assistant Clinical Professor of Ophthalmology at University of South Carolina School of Medicine in Columbia, SC

Diana V. Do, MD
Professor of Ophthalmology and Vice Chair for Clinical Affairs at the Byers Eye Institute, Stanford University School of Medicine.

Mark T. Dunbar, OD, FAAO
Director of Optometric Services Bascom Palmer Eye Institute UHealth - University of Miami Health System.

Steven Ferrucci, OD, FAAO
Chief of Optometry, Sepulveda VA Ambulatory Care Center
Associate Professor, Southern California College of Optometry

Nancy M. Holekamp, MD
Affiliated with Barnes-Jewish Hospital in St Louis, MO
Director of Retina Services at the Pepose Vision Institute in Chesterfield, MO
Professor of Clinical Ophthalmology and Visual Sciences at Washington University School of Medicine in St Louis, MO

Ehsan Rahimy, MD
Ophthalmologist at Mills-Peninsula Medical Center in Burlingame, CA
Machine Learning Physician Consultant at Google LLC in Mountain View, CA
Clinical Instructor of Ophthalmology at Jefferson Medical College in Philadelphia, PA
Director of the Vitreoretinal Disease & Surgery Division in the Department of Ophthalmology at Palo Alto Medical Foundation in Palo Alto, CA

Leo Semes, OD, FAAO
Professor Emeritus of Optometry and Vision Science, University of Alabama at Birmingham

Charlie Wykoff, MD, PHD
Retina Specialist and Ophthalmologist with Retina Consultants of Houston
Director of Research at RCH and the Greater Houston Retina Research Foundation

All presenters were compensated for their time by Regeneron.

02/2021 EYL.21.01.0115

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IMPORTANT SAFETY INFORMATION AND INDICATIONS

CONTRAINDICATIONS

  • EYLEA is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.

WARNINGS AND PRECAUTIONS

  • Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately. Intraocular inflammation has been reported with the use of EYLEA.
  • Acute increases in intraocular pressure have been seen within 60 minutes of intravitreal injection, including with EYLEA. Sustained increases in intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be monitored and managed appropriately.
  • There is a potential risk of arterial thromboembolic events (ATEs) following intravitreal use of VEGF inhibitors, including EYLEA. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The incidence of reported thromboembolic events in wet AMD studies during the first year was 1.8% (32 out of 1824) in the combined group of patients treated with EYLEA compared with 1.5% (9 out of 595) in patients treated with ranibizumab; through 96 weeks, the incidence was 3.3% (60 out of 1824) in the EYLEA group compared with 3.2% (19 out of 595) in the ranibizumab group. The incidence in the DME studies from baseline to week 52 was 3.3% (19 out of 578) in the combined group of patients treated with EYLEA compared with 2.8% (8 out of 287) in the control group; from baseline to week 100, the incidence was 6.4% (37 out of 578) in the combined group of patients treated with EYLEA compared with 4.2% (12 out of 287) in the control group. There were no reported thromboembolic events in the patients treated with EYLEA in the first six months of the RVO studies.

ADVERSE REACTIONS

  • Serious adverse reactions related to the injection procedure have occurred in <0.1% of intravitreal injections with EYLEA including endophthalmitis and retinal detachment.
  • The most common adverse reactions (≥5%) reported in patients receiving EYLEA were conjunctival hemorrhage, eye pain, cataract, vitreous detachment, vitreous floaters, and intraocular pressure increased.
  • Patients may experience temporary visual disturbances after an intravitreal injection with EYLEA and the associated eye examinations. Advise patients not to drive or use machinery until visual function has recovered sufficiently.

INDICATIONS

EYLEA® (aflibercept) Injection 2 mg (0.05 mL) is indicated for the treatment of patients with Neovascular (Wet) Age-related Macular Degeneration (AMD), Macular Edema following Retinal Vein Occlusion (RVO), Diabetic Macular Edema (DME), and Diabetic Retinopathy (DR).

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