Diabetic Retinopathy News

SALT LAKE CITY, March 2008 — Serious eye diseases such as diabetic retinopathy and macular degeneration (AMD) may be treated in the future through activating a certain blood vessel protein that can help reverse or prevent eye damage.

In experiments involving mice, University of Utah School of Medicine researchers found that activity of the protein, Robo4, prevented or reversed abnormal blood vessel growth in the inner back lining of the eye (retina), where vision processing occurs.

Abnormal blood vessel growth causes potentially blinding eye damage in both diabetic retinopathy and AMD.

"Many diseases are caused by injury or inflammation destabilizing blood vessels and causing them to leak fluid into adjacent tissues as well," said Dean Y. Li, MD, PhD, senior author of a study published March 16 in Nature Medicine online.

WAKE FOREST, N.C., September 2007 — Digital Healthcare Inc. has won U.S. Food and Drug Administration approval to begin marketing a device (Retasure) that may help detect early signs of diabetic retinopathy.

Primary care physicians can use Retasure to photograph the eye's inner back interior (retina). These images then can be transmitted over a secure network to a board-certified ophthalmologist for analysis of possible eye damage related to diabetes.

Company officials say Retasure allows approximately 20 million U.S. residents with diabetes to be more easily monitored for possible presence of diabetic retinopathy, enabling earlier treatment. The Retasure system is non-invasive and requires no eye dilation.

CHICAGO, June 2007 — Individuals with type 2 diabetes who develop swelling and thickening of the eye's retina (macular edema) as part of diabetic retinopathy are more likely to report decreased quality of life based on visual function.

Surveys conducted by Chicago investigators found that type 2 diabetics experienced decreased quality of life based on visual function similar to people with glaucoma and type 1 diabetes with diabetic retinopathy.

Results also found visual quality of life among this group to be most similar to people with age-related macular degeneration. Results were reported in the June 21 online version of British Journal of Ophthalmology.

MELBOURNE, Australia, March 2007 — People who have diabetes and eye damage (retinopathy) associated with the disease appear to be at greater risk of developing a stroke, according to study results reported in the February 2007 issue of the journal, Stroke.

Researchers at Australia's University of Melbourne found that the same factors causing damage to blood vessels in the back of the eye (retina), found in diabetic retinopathy, also can be associated with an increased risk of stroke.

These findings suggest that people with diabetic retinopathy also should be monitored for the possibility of developing strokes, researchers said.

CLEVELAND, Ohio, February 2007 — A non steroidal anti-inflammatory drug normally used as an eye drop following cataract surgery, Nepafenac, has been shown to help reduce retinal microvascular problems and other eye abnormalities in diabetic rats.

Results of studies conducted by Cleveland and Fort Worth researchers were published in the February 2007 issue of the American Diabetes Association journal, Diabetes. Study results could have implications for diabetics with eye damage associated with retinopathy.

BALTIMORE, December 2006 — A small study using Lucentis (ranibizumab) as a diabetic retinopathy treatment has demonstrated significant vision improvement in people with early stages of the eye disease, which damages light-sensitive cells in the inner back of the eye (retina).

In the study conducted by researchers at Johns Hopkins Wilmer Eye Institute, all 10 people who received eye injections of Lucentis (Genentech, San Francisco) experienced vision improvement of at least two lines on a standard eye chart after several months of treatment.

People with diabetes sometimes experience vision loss when uncontrolled blood sugar damages blood vessels in the area of the retina, leading to swelling and thickening of the macula where finely detailed focusing occurs (macular edema).

"Within a week, several patients experienced dramatic reductions in the thickness of their maculas, and there were further improvements with each injection," study investigator and ophthalmology professor Peter Campochiaro, MD, said in a news release.

The study was reported in the December 2006 issue of the American Journal of Ophthalmology.

Other positive results related to diabetic retinopathy treatment have been reported for injections of Avastin (Genentech), a form of Lucentis (see news brief below). Lucentis has been FDA-approved for treating macular degeneration, and Avastin is FDA-approved as a cancer treatment.

[Read more about Lucentis and Avastin]

BIRMINGHAM, Ala., December 2006 — Injections of a cancer drug known as Avastin (Genentech, San Francisco) into the eye have been shown in a small, preliminary study to eliminate abnormal blood vessel growth (neovascularization) associated with vision loss in proliferative diabetic retinopathy (PDR).

Medical researchers from Birmingham, Ala., reported complete regression of neovascularization in retinas of three patients with PDR within three weeks after they received injections of Avastin (bevacizumab). Study results including details about each of the three cases were reported in the October 2006 issue of American Journal of Ophthalmology.

[Read more about Avastin as a treatment for macular degeneration.]
 

LA JOLLA, Calif., December 2006 — Usual treatments for diabetic retinopathy and similar eye diseases are aimed at destroying abnormal blood vessels causing leakage in the back of the eye (retina), which is the underlying cause of eye damage and vision loss.

But La Jolla, Calif. researchers at Scripps Research Institute now say they have evidence that these blood vessels should be repaired rather than destroyed to provide effective treatment for diabetic retinopathy and similar retinal diseases such as retinopathy of prematurity (ROP).

A study using mouse models demonstrated that certain types of bone marrow cells (progenitor cells) could be transplanted into the retina to initiate blood vessel repair. Researchers said these results show promise for future development of treatments for eye diseases involving retinal damage from abnormal blood vessel growth.

Study results initially were reported in the November 2006 online issue of Journal of Clinical Investigation and were due for publication in the December 2006 print edition of the journal.

INDIANAPOLIS, October 2006 — Eli Lilly Co. has announced that the U.S. Food and Drug Administration (FDA) now requires an additional three-year clinical trial of a new drug for treatment of diabetic retinopathy, ruboxistaurin mesylate, despite an "approvable" letter granted by the federal agency in August 2006.

The FDA had said the drug appeared approvable, as long as additional evidence was supplied. But the federal agency after negotiating with the company indicated that needed evidence now requires additional investigation and was not found in data contained in current clinical studies.

"We are certainly disappointed with this communication from the FDA," Eli Lilly President and Chief Operating Officer John Lechleiter, PhD, said in a company news release. "Diabetic retinopathy is a significant unmet medical need to which we have devoted more than a decade of clinical research with no guarantee of approval. We still believe that ruboxistaurin has potential as a treatment for diabetic eye disease and are exploring the feasibility of further development of this molecule."

Eli Lilly Co., in collaboration with Alcon Inc., had planned to market the drug under the trade name of Arxxant.

NEWARK, N.J., September 2006 — Progression and damage from diabetic retinopathy occur at a high rate in African Americans with type 1 diabetes, according to a study reported in the September 2006 issue of Archives of Ophthalmology.

Researchers found that poor blood sugar control and high blood pressure among African American populations studied were two controllable factors contributing to the high rate of eye damage from diabetic eye disease.

The New Jersey study evaluated the six-year progression of diabetic retinopathy in 483 African Americans diagnosed with type 1 diabetes.

Authors concluded that more effort should be made to make sure regular, dilated eye examinations are conducted among African American populations with type 1 diabetes to help monitor and reduce potential eye damage from diabetic retinopathy.

WASHINGTON D.C., July 2006 — Ruboxistaurin mesylate (Eli Lilly and Co., Indianapolis, in collaboration with Alcon Inc., Fort Worth) has demonstrated ability to reduce the risk of sustained, moderate vision loss by 41 percent in people with moderate to severe early stage (nonproliferative) diabetic retinopathy.

Findings of early results from clinical investigations of the drug, which has a proposed brand name of Arxxant, were presented in late June at the American Diabetes Association's 66th Annual Scientific Sessions in Washington D.C.

"These data are exciting because they show that ruboxistaurin has the potential to be the first oral therapy to specifically reduce the risk of vision loss caused by diabetic retinopathy," the study's lead investigator Lloyd Paul Aiello, MD, PhD, said in a company news release. Aiello is director of Beetham Eye Institute & Section on Eye Research at Joslin Diabetes Center and is an associate professor of ophthalmology at Harvard Medical School in Boston.

PERTH, Australia, April 2006 — A Retisert drug implant used for treating eye inflammation (uveitis) has been shown in clinical studies also to help stop progression of diabetic retinopathy, an eye disease associated with diabetes that damages tiny blood vessels in the retina.

Two-year study results involving 277 U.S. patients with diabetic retinopathy were announced in late March 2006 by pSivida Limited (Perth, Australia). Three-year study results for Retisert's results associated with diabetic retinopathy were scheduled to be discussed in May 2006 at the annual Association for Research in Vision and Ophthalmology (ARVO) conference in Fort Lauderdale, Fla.

Two-year results were from studies conducted by Bausch & Lomb (Rochester, N.Y.), a license holder and U.S. marketer of the drug. Bausch & Lomb also owns the Retisert trademark. Studies demonstrated that only 10 percent of eyes treated with Retisert (fluocinolone acetonide) had worsening of diabetic retinopathy symptoms, compared with 30 percent of eyes receiving standard laser treatment. Retisert is a corticosteroid with anti-inflammatory properties.

BOSTON, March 2006 — Different study results in recent years indicate that low dose aspirin might help reduce the risk of vision loss from a diabetic eye disease known as diabetic retinopathy.

Patients with diabetic retinopathy should always consult their doctor first before trying any kind of therapy on their own, including low dose aspirin. But positive effects of aspirin as a preventive measure against damage from this diabetic eye disease once again were confirmed in a recent study conducted by Schepens Eye Research Institute, Harvard Medical School, in Boston.

Study results announced in late 2005 demonstrated that low doses of aspirin given to diabetic rats helped reduce swelling and breakdown of tiny blood vessels in the inner back of the eye (retina), a condition associated with diabetic retinopathy. Research is continuing to determine minimal dosages of aspirin that might offer a protective effect against eye damage from diabetic retinopathy.

PHILADELPHIA, January 2006 — GlaxoSmithKline has warned health care providers that patients treated for type 2 diabetes with the company's drugs containing rosiglitazone (Avandia, Avandamet and Avandaryl) could develop new or worsening symptoms of swelling within the inner back layer of the eye (retina), where the macula provides finely detailed focusing.

The U.S. Food and Drug Administration web site in early 2006 posted the GlaxoSmithKline warning letter, which mentions a company proposal to include additional labeling about the risk of potential development of internal eye swelling known as diabetic macular edema.

"GlaxoSmithKline has received very rare post-marketing reports of new onset and worsening diabetic macular edema for patients receiving rosiglitazone...," the letter says. "In some cases, the macular edema resolved or improved following discontinuation of therapy and, in one case, macular edema resolved after dose reduction."

Symptoms of diabetic macular edema include blurry vision, decreased ability to adapt to the dark and decreased color sensitivity.

March 2005 — A study evaluating the use of lubricating eye drops revealed that diabetic patients in a general population are more likely to have dry eye symptoms. Researchers concluded that inadequate blood sugar control in diabetic patients appears associated with development of dry eye.

The study for one year compared electronic medical records of 159,634 patients older than age 50 who lived in a specific district of Israel. The study found that 20.6 percent of diabetic patients needed lubricating eye drops, compared with 13.8 percent of non-diabetic patients. The study, reported in the American Journal of Ophthalmology, also found significantly increased use of lubricating eye drops among diabetic patients who had poor blood sugar control.

March 2005 — Diabetic patients with vision defects associated with swelling in the back, inner area of the eye where images are processed (macula and retina) may be helped by a drug called triamcinolone acetonide, the British Journal of Ophthalmology reported. Positive though temporary results were noted in the German study conducted by University of Heidelberg researchers, who injected 97 eyes of 81 diabetic patients with triamcinolone acetonide. The drug is a corticosteroid with anti-inflammatory properties.

After four months 68 percent of eyes receiving the injection temporarily gained at least two lines of vision improvement on a standard Snellen eye chart. Effectiveness continued for up to seven months following injections. A control group of diabetic patients had no vision improvement or their vision worsened during the same period. Researchers said more study is needed to determine proper dosage for injections or devices that would slowly release the drug into the eye. Side effects include increased internal eye pressure (intraocular pressure), which can damage the optic nerve if uncontrolled.