This is the second iteration of the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) joining forces to write guidelines on the management of diabetes mellitus (DM), pre-diabetes, and cardiovascular disease (CVD), designed to assist clinicians and other healthcare workers to make evidence-based management decisions. The growing awareness of the strong biological relationship between DM and CVD rightly prompted these two large organizations to collaborate to generate guidelines relevant to their joint interests, the first of which were published in 2007. Some assert that too many guidelines are being produced but, in this burgeoning field, five years in the development of both basic and clinical science is a long time and major trials have reported in this period, making it necessary to update the previous Guidelines.

/pdf/2019-esc-guidelines-on-diabetes-pre-diabetes-and-4treq2fwvr.pdf

2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD

/pdf/esc-guidelines-on-diabetes-pre-diabetes-and-cardiovascular-7k2pvnsifc.pdf

ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD)

Ranibizumab for Diabetic Macular Edema: Results from 2 Phase III Randomized Trials: RISE and RIDE

Background The relative efficacy and safety of intravitreous aflibercept, bevacizumab, and ranibizumab in the treatment of diabetic macular edema are unknown. Methods At 89 clinical sites, we randomly assigned 660 adults (mean age, 61±10 years) with diabetic macular edema involving the macular center to receive intravitreous aflibercept at a dose of 2.0 mg (224 participants), bevacizumab at a dose of 1.25 mg (218 participants), or ranibizumab at a dose of 0.3 mg (218 participants). The study drugs were administered as often as every 4 weeks, according to a protocol-specified algorithm. The primary outcome was the mean change in visual acuity at 1 year. Results From baseline to 1 year, the mean visual-acuity letter score (range, 0 to 100, with higher scores indicating better visual acuity; a score of 85 is approximately 20/20) improved by 13.3 with aflibercept, by 9.7 with bevacizumab, and by 11.2 with ranibizumab. Although the improvement was greater with aflibercept than with the other two drugs (P 0.50 for each pairwise comparison). When the initial letter score was less than 69 (approximately 20/50 or worse), the mean improvement was 18.9 with aflibercept, 11.8 with bevacizumab, and 14.2 with ranibizumab (P Conclusions Intravitreous aflibercept, bevacizumab, or ranibizumab improved vision in eyes with center-involved diabetic macular edema, but the relative effect depended on baseline visual acuity. When the initial visual-acuity loss was mild, there were no apparent differences, on average, among study groups. At worse levels of initial visual acuity, aflibercept was more effective at improving vision. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT01627249.).

/pdf/aflibercept-bevacizumab-or-ranibizumab-for-diabetic-macular-2ycepsgbe7.pdf

Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema.

Diabetic retinopathy (DR) is a leading cause of vision-loss globally. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one third have signs of DR and of these, a further one third of DR is vision-threatening DR, including diabetic macular edema (DME). The identification of established modifiable risk factors for DR such as hyperglycemia and hypertension has provided the basis for risk factor control in preventing onset and progression of DR. Additional research investigating novel risk factors has improved our understanding of multiple biological pathways involved in the pathogenesis of DR and DME, especially those involved in inflammation and oxidative stress. Variations in DR prevalence between populations have also sparked interest in genetic studies to identify loci associated with disease susceptibility. In this review, major trends in the prevalence, incidence, progression and regression of DR and DME are explored, and gaps in literature identified. Established and novel risk factors are also extensively reviewed with a focus on landmark studies and updates from the recent literature.

/pdf/epidemiology-of-diabetic-retinopathy-diabetic-macular-edema-16vzgjcxp4.pdf

Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss

https://oftalmologiarafaelcaiado.files.wordpress.com/2012/04/restore-lu-dme-cc3b3pia1.pdf

The RESTORE Study: Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

A Phase 2 Study (EMERGE) Evaluating Repeated Intravitreal Administration of ICON-1 in Patients With Choroidal Neovascularization (CNV) Secondary to Age-related Macular Degeneration (AMD)

The present invention relates to the use of a VEGF antagonist in the treatment of chorioretinal neovascular or permeability disorders in children. In particular, the invention provides a VEGF antagonist for use in a method for treating a child having CNV or ME, wherein said method comprises administering to the eye of a child a VEGF antagonist that either does not enter or is rapidly cleared from the systemic circulation. The VEGF antagonist may be administered intravitreally, e.g. through injection, or topically, e.g. in form of eye drops. The invention further provides the use of a VEGF antagonist in the manufacture of a medicament for treating a child having a chorioretinal neovascular or permeability disorder.

Use of a vegf antagonist in treating chorioretinal neovascular and permeability disorders in paediatric patients

The present invention relates to the use of a VEGF antagonist in the treatment of retinal neovascular disorders in infants. In particular, the invention provides a method for treating an infant having retinopathy of prematurity (ROP), wherein said method comprises administering to the eye of an infant a VEG F antagonist that either does not enter or is rapidly cleared from the systemic circulation. The term "infant'' is typically used to refer to young children from birth up to the age of 12 months. The VEGF antagonist may be administered intravitreally, e.g. through injection, or topically, e.g. in form of eye drops.

Gabriela Burian

Papers

The RESTORE Study: Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

Ranibizumab Monotherapy or Combined with Laser versus Laser Monotherapy for Diabetic Macular Edema

A Phase 2 Study (EMERGE) Evaluating Repeated Intravitreal Administration of ICON-1 in Patients With Choroidal Neovascularization (CNV) Secondary to Age-related Macular Degeneration (AMD)

Use of a vegf antagonist in treating chorioretinal neovascular and permeability disorders in paediatric patients

Use of a vegf antagonist in treating retinopathy of prematurity