New Study Compares Drug Treatments for Diabetic Eye Disease

OHSU Casey Eye Institute one of 88 study sites participating in pivotal DME investigation

For the millions of Americans living with diabetes, one of the most worrisome complications is diabetic macular edema (DME), a type of eye problem that can threaten vision. Regular injections of medications into the eye, as well as laser therapy, are the mainstay treatments.

Now, a recent government study comparing the three primary drugs used to treat DME – Eylea, Avastin and Lucentis – offers important evidence on their effectiveness. Researchers found that after one year Eylea worked better for patients with “moderate” vision loss than Avastin and Lucentis, when vision was 20/50 or worse at the start of the trial.  The study, conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net), also discovered that the three drugs performed about the same when starting vision was 20/40 to 20/32. Investigators found no major differences in the safety of the three drugs.

“These results will help eye doctors and patients make informed decisions when choosing treatments for DME,” says Andreas Lauer, M.D., Kenneth C. Swan Professor of Ophthalmology and principal investigator of the study at OHSU Casey Eye Institute.  Other members of the Casey research team were Christina Flaxel, M.D., professor of ophthalmology and Steven Bailey, M.D., associate professor of ophthalmology.

DME is a common cause of vision loss in diabetic retinopathy, a type of diabetic eye disease that can cause the growth of abnormal blood vessels in the retina. Macular edema, or swelling, happens when fluid leaks from these faulty blood vessels and collects in the macula, the part of the eye needed for sharp, straight-ahead vision. DME can occur at any stage of diabetic retinopathy. 

DRCR.net investigators enrolled 660 people with macular edema at 88 clinical trial sites across the United States, including Casey. Each participant randomly received Eylea, Avastin , or Lucentis. Participants were checked monthly and received the assigned study drug by injection directly into the eye until the DME resolved or stabilized.  Laser treatment was given to participants whose DME persisted and was not improving after 6 months of injections.

“Eylea, Avastin or Lucentis are all potentially effective for improving vision in patients with DME.  Eylea appears to additionally benefit patients who start treatment with moderate vision loss,” Dr. Lauer says. “Besides the patient’s starting vision, other factors to consider when deciding treatment include the number of injections or laser needed per year and cost of treatment.”

Casey’s Retina Service has been a strong participant in the Diabetic Retinopathy Clinical Research Network for more than a decade, says Dr. Lauer.  “The research network, which is funded by the National Eye Institute, has investigated numerous study questions in order to improve the care of patients with diabetes who develop diabetic retinopathy,” he adds.  In the United States, diabetic retinopathy remains a leading cause of vision loss and blindness in working aged adults and is fast becoming a significant cause of blindness in developing countries.  

“By continuing our participation in national and international clinical studies, we remain committed to improving the care of patients with retinal diseases in the Pacific Northwest,” says Dr. Lauer.

Learn more about diabetic eye disease.

View an NEI video about how diabetic retinopathy can be detected through a comprehensive dilated eye exam.