UW Ophthalmologists help demonstrate effectiveness of diabetic macular edema treatments

An ophthalmology research team at the University of Wisconsin-Madison took part in a nationwide clinical trial comparing treatments for a form of diabetic eye disease. The study found that three commonly used drugs perform much the same for those with mild vision problems, but one medication performed better for those with more serious vision loss.

The results were published online February 18 in the New England Journal of Medicine. The research was supported by a National Institutes of Health grant to compare treatments of diabetic macular edema (DME). Three drugs–Eylea, Lucentis and Avastin–were compared. All three performed similarly for people with mild DME, while Eylea did better for those who had moderate or worse vision loss.

There were 660 people enrolled at 88 clinical trial sites across the United States. Dr. Justin Gottlieb, chief of retina service at the University of Wisconsin, was the local principal investigator for the trial in Madison.

“Being able to be part of this research is one of the reasons we practice at the UW,” Gottlieb said. “We are able to be part of these studies and to help not only our patients, but people around the world who have DME.”

The UW recruited eight participants to the study. Three have completed two years of follow-up; the other five people will be followed for a full two years.

The results showed when vision was 20/50 or worse at the start of the trial, Eylea (aflibercept) provided greater visual improvement on average for the participants than the other two drugs. Each participant was randomly assigned one of the drugs and received the assigned study drug by injections directly into the eye until DME resolved or stabilized. Patients were evaluated monthly.

Laser treatment was the standard for treatment for DME until the widespread adoption of these drugs a few years ago. Investigators found no major differences in the safety of the three drugs.

Diabetic macular edema can occur in people with diabetic retinopathy, a type of eye disease that can cause growth of abnormal blood vessels in the retina. Swelling or macular edema occurs when the fluid leaks and can distort vision. This affects tasks such as reading, driving and watching television. About 7.7 million Americans have diabetic retinopathy. Of these, about 750,000 have DME.

The study was funded by grants EY14231, EY14229, and EY18817.