Severe Diabetic Retinopathy Leads to Higher Rate of Visual-Function Issues

Those suffering from severe diabetic retinopathy (DR) experience a significant negative effect on their visual function compared to those with lesser forms of the disease, per a new study led by Jeffrey Willis, MD, PhD, a clinical research fellow at Genentech (pictured).

The study examined a generalized US population without separation of participants through racial and ethnic classifications. Previously, studies have provided information on the impact on the quality of life and function of DR on patients but had not generalized their findings to relate the results to a broader US population.

“The data suggests the importance of a comprehensive approach in not only preventing severe levels of DR, but potentially regressing severe levels of DR through the promotion of lifestyle, systemic medical, and focused retinal interventions,” Willis told MD Magazine.

The study examined 1,004 participants aged 40 and older with diabetes, using the Early Treatment Diabetic Retinopathy Study severity scale to differentiate between three levels of acuteness: mild or moderate nonproliferative diabetic retinopathy (NPDR), severe NDPR, and proliferative diabetic retinopathy (PDR).

Participants were given a questionnaire asking about difficulties with reading and tasks such as close-up work like finding items in crowded spaces; vision while mobile, and driving to determine their visual-function burdens.

72.3% of the participants were found to have no retinopathy, compared to 25.4% with mild to moderate NDPR and 2.3% with severe NDPR or PDR. Those without retinopathy and with mild to moderate NDPR suffered visual-related function burdens at 20.2% and 20.4% rates, respectively.

Meanwhile, those with severe NDPR or PDR suffered at more than double the rate (48.5%).

The findings showed that “among US adults with diabetes, approximately half of those with severe NPDR or PDR had difficulty with at least one visual function task,” according to study authors. They also suggested the findings suggested the importance of severe DR prevention to aid patients’ visual function.

“Moreover, vision-related functional burden was significantly greater among those with severe NPDR or PDR than among those with no retinopathy,” Willis and colleagues wrote. However, the authors stated that those with severe NDPR or PDR did not have statistically significantly higher odds to suffer vision-related burdens compared to those with mild to moderate NDPR.

Currently, the only medicine approved by the US Food and Drug Administration (FDA) that can treat all forms of diabetic retinopathy is ranibizumab injection (Lucentis). It was approved in April 2017.

“Given that [Anti—vascular endothelial growth factor (anti-VEGF) therapy] for diabetic eye disease has been shown to contribute to DR regression, anti-VEGF therapy could potentially enhance the visual function of patients with severe forms of DR,” Willis told MD Magazine. “There is a need for future studies to investigate the impact of DR regression on visual function.”

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