Seeing A New Way For Diabetic Retinopathy

Robert (Bob) Vitti and Alyson Berliner sit down to discuss their motivations for studying diabetic retinopathy (DR) and how their job was to shift the mindset around the disease.

Bob: For me, the connection to diabetic retinopathy is personal. My grandmother suffered from it and her vision loss significantly impacted the end of her life. She had uncontrolled diabetes and I remember the frustration in not being able to help her; it’s one of the main reasons why I chose to go to medical school and study ophthalmology.

Alyson: I have a personal connection as well, not to diabetes, but to vision loss later in life. Both of my grandmothers suffered significant vision loss and while they didn’t have diabetes, the depression, confusion and frustration they felt was very real and, I imagine, consistent with the experience of people who lose their vision from diabetic retinopathy.

Bob: And when you see the growing number of people in America with diabetes or pre-diabetes —100 million by some counts – who are now at risk for vision loss as a result of this disease, there is no other way to describe it other than a ticking time bomb!

Alyson: Yes, think about that: nearly one third of the country has or is at risk for developing diabetes. And many don’t associate vision loss as a complication of diabetes. This is a real problem because when severe diabetic retinopathy complications set in, it’s unfortunately too late in many cases.

Bob: When my grandmother was experiencing vision loss, the options were very limited. And as recently as a decade ago, the treatment mindset was completely different—the only options were watching and waiting or maybe laser treatment. So, when we set out to design a clinical trial to explore a different approach, we were really setting out to potentially shift the paradigm of the disease: we hypothesized that earlier and consistent treatment could make an impact and prevent some diabetic-related blindness.

Alyson: Exactly. Creating a conversation isn’t easy but we believe empowering doctors and patients to take control and discuss the impact diabetes can have on patients’ vision is important. Through clinical research, we bore out this hypothesis and showed that, with early treatment, a reduction of the likelihood of developing vision-threating events is possible. This gives doctors the knowledge and confidence to ask, am I doing the most for my patients with diabetes? Is waiting until something bad happens and then trying salvage vision enough?

Bob: It’s really about empowerment, like you said. And that’s why I’m so proud to have spent the last twelve years here at Regeneron, where we were empowered to ask tough questions like these and follow the science.

1. National Eye Institute. Statistics and data: diabetic retinopathy. National Institutes of Health: National Eye Institute Web site. https://nei.nih.gov/eyedata/diabetic. Accessed June 12, 2018.
2. American Optometric Association. Diabetic retinopathy. AOA Web site. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/diabetic-retinopathy. Accessed June 12, 2018.
3. Retinal diseases/health series. American Society of Retina Specialists (ASRS) Web site. https://www.asrs.org/patients/retinal-diseases. Accessed June 12, 2018.
4. Woodcock A et al. The influence of diabetic retinopathy on quality of life to guide the design of a conditionspecific, individualized questionnaire: the retDQoL. Patient Educ Couns. 2004; 55:365-83.
5. Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2011.
6. Zhang X, Saaddine JB, Chou CF, et al. Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010;304(6):649-656.