9.12 Summary

Summary

The treatment paradigms for the treatment of DME are rapidly evolving. Vascular endothelial growth factor (VEGF) has been shown to play a central role in DME. This has driven research efforts for the development of several agents that block the actions of VEGF in the retina. Anti-VEGF treatment represents a major advance in the management of DME.

Test Module 9

1. The first drug to be approved for the use of treating neovascularization for intraocular use was

2. Vascular endothelial growth factor concentrations are elevated in the eyes of patients with DME.

3. Which agents have been responsible for a paradigm shift in the treatment of DME and are now sometimes used as first-line agents?

4. Avastin (bevacizumab) was originally approved for the treatment of:

5. The VEGF causes breakdown of the blood retinal barrier by acting upon

6. Bevacizumab is currently approved by the FDA for the treatment of all of the diseases below except:

7. What study will be comparing the efficacy and safety of bevacizumab, ranibizumab, and aflibercept?

8. What is one of the drawbacks to the use of bevacizumab for DR and DME?

9. There are currently numerous large-scale clinical results to support the use of bevacizumab for the treatment of DME and PDR.

10. Which of the anti-VEGF agents used for DME has been the most thoroughly studied?

11. Which of the following is not correct?

12. Which of the following studies demonstrated the efficacy and safety of ranibizumab for the treatment of DME?

13. Which of the following is not a factor in visual function for patients with DME?

14. Which anti-VEGF agent has been shown to bind to all isomers of the VEGF-A family, VEGF-B, and placental growth factor?

15. What percentage of patients have been shown to experience clinically relevant increases in visual acuity with anti-VEGF agents?

16. Which study demonstrated the effectiveness of aflibercept for DME?

17. The ETDRS demonstrated focal laser treatment of CSME decreased the risk of vision loss by approximately

18. Which of the follow is not a complication associated with conventional laser treatment?

19. In general, lasers have evolved to include all of the following except:

20. What was the landmark study that helped to confirm the utility of focal laser photocoagulation?

21. What are two important mechanisms for corticosteroid actions applicable to the treatment of DME?

22. Which of the following corticosteroids are available as intravitreal inserts for the treatment of DME?

23. One of the primary anti-inflammatory mechanisms of corticosteroids is their inhibition of the arachidonic acid cascade.

24. What are some obvious advantages of administering corticosteroids via intravitreal inserts compared with intravitreal injections?

25. Which of the following agents has anti-VEGF activity?

26. Which of the following appears to activate the Tie-2 pathway, a key control axis for retinal vascular stability?

27. It is important that the clinician be familiar with findings from clinical trials such as Diabetic Retinopathy Study, Early Treatment Diabetic Retinopathy Study, and the Diabetic Retinopathy Vitrectomy Study in order to aid in the diagnosis and treatment of their patients with DR and DME.

28. Which of the following is more likely to be the most important factor, from both a physician and a patient perspective, in making treatment recommendations for patients with DR and or DME?

29. Which anti-angiogenic small molecule has been evaluated in drop form?

30. Vitrectomy is a technique that shows benefits over other treatments for all type of patients with DME.

31. Which of the following is not a potential mechanism of action for vitrectomy?

32. Vitrectomy can be a useful treatment for patients with epiretinal membranes or vitreomacular traction.

33. The role of vitrectomy in the management of refractory DME is well defined.

34. There is a high correlation between baseline best corrected visual acuity (BCVA) and macular thickness in patients with persistent macular edema.