Ryuya Hashimoto, MD, PhD
Toho University Sakura Medical Center, Chiba, Japan
The 2024 FujiRetina meeting featured standout presentations during the surgical session dedicated to diabetic retinopathy, engaging the audience in both insightful discussions and innovative research revelations.
The session commenced with Professor Masahiko Shimura of Tokyo Medical University Hachioji Medical Center, Japan, delineating his study on the aqueous humor concentrations of VEGF, Ang-1, and Ang-2 at the time of faricimab injections in treatment-naive diabetic macular edema (DME) patients. This retrospective analysis indicated a significant reduction in these proteins correlating with improvement in visual acuity and central retinal thickness. Notably, the aqueous Ang-1 levels in DME patients were lower than those of normal controls and were found to be suppressed by faricimab therapy.
Following was Professor Shintaro Nakao of Juntendo University, Japan, who elucidated the distinctive roles that heterotypic mononuclear phagocytes play in the pathophysiology of retinal ischemia and neovascularization in diabetic retinopathy. His team’s research suggested that targeting MCP-1 could ameliorate retinal ischemia, as shown in animal models. The scRNA-seq analysis underscored distinct clusters of ischemia-associated macrophages expressing M1 markers, including CCR2, proposing that such heterotypic macrophages/microglia could be viable cellular targets in therapeutic strategies for retinal ischemia in DR.
Professor Yasuki Ito of Fujita Health University, Japan, offered insights into macular edema post-phacovitrectomy for epiretinal membrane. Investigating the prophylactic application of topical NSAIDs and the potential association with primary posterior capsulotomy, the study disclosed that primary capsulotomy did not correlate with a decreased incidence of macular edema when topical steroids and nepafenac were used.
Finally, Professor Masahiko Sugimoto of Yamagata University, Japan, presented on the effects of pregnancy on the progression of diabetic retinopathy. By differentiating between normal DM models and DM combined with pregnancy models (DM+P model) created using Akita mice, the study demonstrated that retinal VEGF expression was reduced in the DM+P model group, while interleukin-9 levels were markedly higher than in the DM group alone. Complementing the animal data, their research into the correlation between the foveal avascular zone (FAZ) and gestational weeks in pregnant women showed a negative correlation, indicating a unique pathophysiological mechanism at play in diabetes during pregnancy.
These presentations underscore the dynamic and multifactorial nature of diabetic retinopathy and highlight the importance of continued research in the development of targeted treatments.