Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema

Carmen A. Puliafito, Scott W. Cousins, Jason Bacharach, Victor H. Gonzalez, Nancy M. Holekamp, Pauline T. Merrill, Matthew P. Ohr, Richard K. Parrish, Christopher D. Riemann

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti-vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use. A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.

Original languageEnglish (US)
Pages (from-to)S4-S15
JournalOphthalmic surgery, lasers & imaging retina
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Macular Edema
Consensus
Physicians
Vascular Endothelial Growth Factor A
Fluocinolone Acetonide
Therapeutics
Pathology
Cytokines
United States Food and Drug Administration
Intraocular Pressure
Cataract
Patient Selection
Dexamethasone
Visual Acuity
Intercellular Signaling Peptides and Proteins
Adrenal Cortex Hormones
Down-Regulation
Drug Therapy

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

Cite this

Puliafito, C. A., Cousins, S. W., Bacharach, J., Gonzalez, V. H., Holekamp, N. M., Merrill, P. T., ... Riemann, C. D. (2016). Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema. Ophthalmic surgery, lasers & imaging retina, 47(4), S4-S15. https://doi.org/10.3928/23258160-20160224-01

Forming a Consensus : Data and Guidance for Physicians Treating Diabetic Macular Edema. / Puliafito, Carmen A.; Cousins, Scott W.; Bacharach, Jason; Gonzalez, Victor H.; Holekamp, Nancy M.; Merrill, Pauline T.; Ohr, Matthew P.; Parrish, Richard K.; Riemann, Christopher D.

In: Ophthalmic surgery, lasers & imaging retina, Vol. 47, No. 4, 01.04.2016, p. S4-S15.

Research output: Contribution to journalArticle

Puliafito, CA, Cousins, SW, Bacharach, J, Gonzalez, VH, Holekamp, NM, Merrill, PT, Ohr, MP, Parrish, RK & Riemann, CD 2016, 'Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema', Ophthalmic surgery, lasers & imaging retina, vol. 47, no. 4, pp. S4-S15. https://doi.org/10.3928/23258160-20160224-01
Puliafito, Carmen A. ; Cousins, Scott W. ; Bacharach, Jason ; Gonzalez, Victor H. ; Holekamp, Nancy M. ; Merrill, Pauline T. ; Ohr, Matthew P. ; Parrish, Richard K. ; Riemann, Christopher D. / Forming a Consensus : Data and Guidance for Physicians Treating Diabetic Macular Edema. In: Ophthalmic surgery, lasers & imaging retina. 2016 ; Vol. 47, No. 4. pp. S4-S15.
@article{fd55d08634054280bdb15d0443e24466,
title = "Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema",
abstract = "The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti-vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use. A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.",
author = "Puliafito, {Carmen A.} and Cousins, {Scott W.} and Jason Bacharach and Gonzalez, {Victor H.} and Holekamp, {Nancy M.} and Merrill, {Pauline T.} and Ohr, {Matthew P.} and Parrish, {Richard K.} and Riemann, {Christopher D.}",
year = "2016",
month = "4",
day = "1",
doi = "10.3928/23258160-20160224-01",
language = "English (US)",
volume = "47",
pages = "S4--S15",
journal = "Ophthalmic Surgery Lasers and Imaging Retina",
issn = "2325-8160",
publisher = "Slack Incorporated",
number = "4",

}

TY - JOUR

T1 - Forming a Consensus

T2 - Data and Guidance for Physicians Treating Diabetic Macular Edema

AU - Puliafito, Carmen A.

AU - Cousins, Scott W.

AU - Bacharach, Jason

AU - Gonzalez, Victor H.

AU - Holekamp, Nancy M.

AU - Merrill, Pauline T.

AU - Ohr, Matthew P.

AU - Parrish, Richard K.

AU - Riemann, Christopher D.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti-vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use. A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.

AB - The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti-vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use. A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.

UR - http://www.scopus.com/inward/record.url?scp=85015603667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015603667&partnerID=8YFLogxK

U2 - 10.3928/23258160-20160224-01

DO - 10.3928/23258160-20160224-01

M3 - Article

C2 - 27096289

AN - SCOPUS:85015603667

VL - 47

SP - S4-S15

JO - Ophthalmic Surgery Lasers and Imaging Retina

JF - Ophthalmic Surgery Lasers and Imaging Retina

SN - 2325-8160

IS - 4

ER -