Patients with diabetic retinopathy (DR) experience retinal damage that can lead to vision impairment and eventual blindness, especially with the development of diabetic macular edema (DME). DME patients are typically treated with intravitreal VEGF inhibitors, either off-label Avastin or the approved agents Eylea and Lucentis 0.3 mg. However, debate continues as to which agent should be started first and how quickly treatment should be initiated. The long-acting corticosteroid implants Ozurdex and Iluvien are also approved for DME, but ophthalmologists usually reserve them for later lines because of their risk / benefit profiles. Eylea’s approval for all stages of DR in May 2019, which follows Lucentis 0.3 mg’s approval for the same indication in 2017, provides ophthalmologists with additional treatment options for their DR patients without DME. However, with panretinal laser photocoagulation (PRP) being the standard of care for proliferative DR (PDR), the most advanced form of DR, and severe nonproliferative DR (NPDR) patients often not receiving ophthalmic medical intervention, it is important to understand if VEGF inhibitors have been incorporated into clinical practice for these patients and what has driven their uptake.


  • What are the drivers and constraints influencing physicians’ treatment decisions for severe NPDR, PDR, and DME? How are DME patients being treated in different lines of therapy?
  • What patient shares do Avastin, Eylea, and Lucentis hold in severe NPDR, PDR, and DME? How do ophthalmologists / retinal specialists anticipate treating these patient populations one year from now?
  • What are the main obstacles to physicians administering Avastin, Eylea, and Lucentis to more of their severe NPDR, PDR, and DME patients?
  • What are the most influential factors driving ophthalmologists / retinal specialists to administer the current VEGF inhibitors to their patients?
  • How are the corticosteroid implants Iluvien and Ozurdex being used in the treatment of DME? What are the primary drivers of and obstacles to their use?


Current Treatment: Provides physician insights on prescribing behavior, treatment paths, and the factors and perceptions driving brand usage so you can understand each brand’s performance and improve or defend your competitive position.

Markets covered: United States

Primary research: Survey of 101 ophthalmologists / retinal specialists in the United States.

Key companies: AbbVie, Alimera Sciences, Genentech, Regeneron

Key drugs: Avastin, Eylea, Iluvien, Lucentis, Ozurdex, triamcinolone

Key insights provided:

  • Factors influencing disease management and treatment decisions.
  • Drivers and constraints of treatment selection.
  • Physician-reported treatment practices and brand-level patient shares.
  • Rationale for changes in treatment approach.
  • Physician insight on persistency and compliance.
  • Physician-reported recent / anticipated changes in brand usage or treatment approach.

Table of contents

  • Diabetic Macular Edema / Diabetic Retinopathy - Current Treatment - Detailed, Expanded Analysis (US)

Author(s): Thomas Cronin

Since joining DRG in late 2019, Tom has worked on reports focusing on psychiatric and ophthalmologic disorders for the CNS team. His background is in biochemistry and he previously worked in the intellectual property field as a registered Patent Agent. Prior to joining DRG, Tom was an Intellectual Property Manager in a Boston-based biopharmaceutical company focusing on treating metabolic diseases and disorders. He has also worked for several internationally recognized law firms representing corporate and institutional clients in all matters of life science – related intellectual property.

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