Tom a 62-year-old man with recently diagnosed clinically significant diabetic macular edema in both eyes

Retina Rounds: Diabetic Macular Edema
0.5 AMA PRA Category 1 Credit(s)
Launch Date:
April 15, 2014
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Retina specialists, comprehensive ophthalmologists

Relevant Terms:

Diabetic Macular Edema, Diabetic Retinopathy, Retinal Disease

Carl D. Regillo, MD, FACS

Carl D. Regillo, MD, FACS
Director, Retina Service
Wills Eye Hospital
Professor of Ophthalmology
Thomas Jefferson University
School of Medicine
Philadelphia, PA

Carl D. Regillo, MD, FACS, is Professor of Ophthalmology at Thomas Jefferson University School of Medicine and Director, Retina Service, at the Wills Eye Hospital in Philadelphia, Pennsylvania. Dr Regillo received his medical degree from Harvard Medical School, and completed an internal medicine internship at Harvard's Brigham and Women's Hospital in Boston. He was appointed Co-Chief Resident during his ophthalmology residency at Wills Eye Institute, where he was given a prestigious Heed Ophthalmic Fellowship in vitreoretinal disease.

As Principal Investigator on major international clinical trials, Dr Regillo is currently researching new treatments for macular degeneration, diabetic retinopathy, and other retinal diseases. He is currently involved in studies of stem cell transplants and various new treatments for age-related macular degeneration; intravitreal aflibercept, fluocinolone acetonide, and ranibizumab for diabetic macular edema; and a home vision monitoring device, among others. Dr Regillo has authored over 100 scientific papers, 8 major textbooks, and more than 30 book chapters, and has lectured at national and international conferences. He serves on the editorial boards of Advanced Ocular Care, Retina Today, Ophthalmology Times, Ocular Surgery News, Retinal Physician, Ocular Surgery Retina, and Current Opinion in Ophthalmology, and is Co-Editor of the Retinal Insider section of Review of Ophthalmology. Dr Regillo is on the Board of Directors of the Pan-American Association of Ophthalmology and is an active member of several other professional societies. The American Academy of Ophthalmology has presented Dr Regillo with a Senior Achievement Award and the Secretariat Award, and he has received a Senior Honor Award from the American Society of Retina Specialists. He was named a "U.S. News Top Doctor" in 2011, and Philadelphia Magazine has ranked Dr Regillo as an ophthalmology-retina "Top Doc" for the past 10 consecutive years. He was listed in Ocular Surgery News as one of 150 "Top Innovators" for his work in retinal disease. Previously, while serving 4 years in the military as a vitreoretinal surgeon, Dr Regillo was Co-Director of the San Diego Naval Medical Center's Retina Service and received a Naval Commendation Medal.

Timothy W. Olsen, MD

Timothy W. Olsen, MD
Director, Emory Eye Center
F. Phinizy Calhoun Sr. Professor of Ophthalmology
Chairman, Department of Ophthalmology
Emory University
Atlanta, GA

Timothy W. Olsen, MD, is the F. Phinizy Calhoun Sr. Professor of Ophthalmology, Chairman of the Department of Ophthalmology, and Director of the Emory Eye Center at Emory University in Atlanta, Georgia. He received his medical degree from the University of Kansas School of Medicine. He completed his residency training in ophthalmology at the University of Minnesota in Minneapolis and his fellowship in vitreoretinal diseases and surgery at Emory University.

Dr Olsen's clinical expertise lies in age-related macular degeneration, diabetic retinopathy, complex retinal detachment surgery, and pediatric retinal disorders, while his research currently focuses on advanced stage age-related macular degeneration. In his career, he has obtained over $5.8 million in research support as a Principal Investigator for macular degeneration and vision research. He has authored more than 100 publications and has presented over 200 regional, national, or international lectures.
Dr Olsen serves as an executive editor of the American Journal of Ophthalmology and on the editorial board of Investigative Ophthalmology and Visual Sciences. He is chair of the Retina Preferred Practice Pattern, Maintenance of Certification, and Practicing Ophthalmologist Committees for the American Academy of Ophthalmology. He is also a Gold Fellow of the Association for Research in Vision and Ophthalmology (ARVO), as well as a member of The Macula Society, The Retina Society, and the American Ophthalmological Society.

George A. Williams, MD

George A. Williams, MD
Chair, Department of Ophthalmology
Director, Beaumont Eye Institute
William Beaumont Hospital
Royal Oak, MI

George A. Williams, MD, is Chair, Department of Ophthalmology, Director of the Beaumont Eye Institute, and Vice Chief of Surgical Services for Academic Affairs at William Beaumont Hospital in Royal Oak, Michigan. He is Professor and Chair of Ophthalmology at Oakland University William Beaumont School of Medicine and a partner with Associated Retinal Consultants. He is also on the faculty of the European School for Advanced Studies in Ophthalmology in Lugano, Switzerland. Dr Williams received his medical degree from Northwestern University Feinberg School of Medicine and completed his residency in ophthalmology and his fellowship in vitreoretinal surgery at the Eye Institute of the Medical College of Wisconsin.
Dr Williams has published over 200 articles and book chapters in the field of vitreoretinal surgery. He has participated as Principal Investigator or Co-Investigator in over 20 clinical trials. He served on the Board of Trustees of the American Academy of Ophthalmology (AAO) from 2008 to 2012. Dr Williams is a recipient of the Special Recognition Award, the Secretariat Award, and the Lifetime Achievement Award of the AAO. He is past chair of the Retina Ophthalmic Technology Assessment Committee and a member of the Health Policy Committee of the AAO. Dr Williams represents the AAO as a member of the Relative Value Scale Update Committee of the American Medical Association. He is past president of the American Society of Retina Specialists and the Michigan Society of Eye Physicians and Surgeons. In addition, Dr Williams serves on the editorial board of the journals, Retina, Retinal Physician, Retinal Cases and Brief Reports, and Current Opinion in Ophthalmology. He is also an associate examiner for the American Board of Ophthalmology and a member of The Retina Society, The Macula Society, the American Society of Retina Specialists, the Association of University Professors in Ophthalmology, and the Club Jules Gonin.
1. Discuss with patients how poorly controlled blood glucose and other comorbidities contribute to diabetic retinopathy progression
2. Identify management strategies for their patients with DME based on associated risks and benefits and on patient factors, including visual acuity and retinal disease severity
3. Assess and monitor patient factors that may potentially increase their risk for ocular and/or systemic complications after receiving intravitreal injections
4. Evaluate patient factors including changes in visual acuity and retinal thickness to measure their treatment response and adjust their management plan if needed

Wills Eye Hospital is accredited by the ACCME to provide continuing medical education for physicians.

Wills Eye Hospital designates this live activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All faculty participating in continuing medical education programs sponsored by Wills Eye Hospital are expected to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation(s). Disclosure statements for the faculty moderators are available in the handout containing their biography.

Carl D. Regillo, MD, FACS
Consulting Fees: Alimera Sciences; Allergan, Inc; Genentech, Inc; Regeneron Pharmaceuticals, Inc
Fees for Non-CME Services Received Directly from Commercial Interest or Their Agents: Genentech, Inc
Contracted Research: Alimera Sciences; Allergan, Inc; Genentech, Inc; Regeneron Pharmaceuticals, Inc
Timothy W. Olsen, MD
Contracted Research: National Institutes of Health; National Eye Institute
George A. Williams, MD
Salary: OMIC (Ophthalmic Mutual Insurance Company)
Royalty: ForSight VISION4, Inc; OptiMedica Corporation
Receipt of Intellectual Property Rights/Patent Holder: OptiMedica Corporation
Consulting Fees: Alcon; Allergan, Inc; ForSight VISION4, Inc; OptiMedica Corporation;
Contracted Research: Alcon; Allergan, Inc
Ownership Interest: ForSight VISION4, Inc; OptiMedica Corporation
Alex Yuan, MD, PhD
Cole Eye Institute
Cleveland Clinic
Cleveland, OH
Nothing to disclose with regard to commercial support
Educational Planning Committee
Wills Eye Hospital
Vaughn Wurst
Nothing to disclose with regard to commercial support
Spire Learning
Christine Kocienda
Shareholder (spouse/partner): Johnson & Johnson; Procter & Gamble
Jeanne Prater
Shareholder (spouse/partner): Johnson & Johnson
Employee (spouse/partner): Novo Nordisk
Jaime Symowicz, PhD
Nothing to disclose with regard to commercial support
The opinions expressed in this educational activity are those of the faculty, and do not represent those of Wills Eye Hospital or Spire Learning. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically, and draw conclusions only after careful consideration of all available scientific information.
In this educational activity, the faculty discuss the non-FDA-approved or investigational use of bevacizumab, aflibercept, triamcinolone, and dexamethasone intravitreal implant for diabetic macular edema.

Level I includes evidence obtained from at least one properly conducted, well-designed, randomized controlled trial. It could include meta-analyses of randomized controlled trials.
Level II includes evidence from the following:

  • Well-designed controlled trials without randomization
  • Well-designed cohort or case-control analytic studies, preferably from more than one center
  • Multiple time-series with or without intervention
Level III includes evidence obtained from one of the following:
  • Descriptive studies
  • Case reports
  • Reports of expert committees/organizations (eg. PPP panel consensus with external peer review)
Source: American Academy of Ophthalmology Preferred Practice Patterns® (PPP) Guidelines

This activity is jointly sponsored by Wills Eye Hospital and Spire Learning.

This activity is supported by an independent educational grant from Genentech.

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