Early Treatment of Diabetic Retinopathy and Diabetic Macular Edema: Optimal Use of Anti-VEGF Therapy for Vision Preservation and Restoration
Release Date: September 8, 2017
Last Reviewed: August 29, 2017
Expiration Date: September 8, 2018
Time to Complete Activity:  1.25 hours
*This activity expired for credit on September 8, 2018 and is no longer available for credit
This activity is provided by Global Education Group.  Paradigm Medical Communications, LLC, is the educational partner.
Nancy M. Holekamp, MD
Professor of Clinical Ophthalmology
Washington University School of Medicine
St. Louis, MO
Arshad M. Khanani MD, MA
Clinical Associate Professor
University of Nevada, Reno
Managing Partner and Director of Clinical Trials
Sierra Eye Associates
Reno, NV
Target Audience
This activity has been designed to address the educational needs of retina specialists and comprehensive ophthalmologists. It may also benefit other healthcare providers (HCPs) interested in the management of diabetic retinopathy (DR) and diabetic macular edema (DME).
Statement of Need
Diabetic retinopathy (DR) and diabetic macular edema (DME) are 2 of the most common causes of blindness among working-age people throughout the world. Effective management depends heavily on prompt treatment. Many of these patients remain untreated, however; as a result, they often suffer irrevocable vision loss that might have been prevented. Retina specialists and comprehensive ophthalmologists, who play a crucial role in the treatment of DR and DME, will require education to overcome deficits in their knowledge of anti-VEGF therapies for DR and DME, including recent study data elucidating important differences in the safety, efficacy, pharmacology, cost-effectiveness, and delivery of these agents. The interactive video webinar will provide a case-enhanced, expert-led review of anti-VEGF agents (including discussion of a new anti-VEGF delivery mechanism and seminal Protocol S and Protocol T study data), to help retina specialists and comprehensive ophthalmologists provide the early intervention needed to maximize visual outcomes in patients with DME and/or DR.
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Review recent safety and efficacy data related to anti-VEGF agents commonly used to treat diabetic retinopathy and diabetic macular edema.
  • Summarize evidence concerning the ease of administration, cost-effectiveness, and pharmacology of anti-VEGF agents used to treat diabetic retinopathy and diabetic macular edema.
Table of Contents
Chapter 1: Diabetic Macular Edema with Nonproliferative Diabetic Retinopathy
  • Case Study 1: 59-y-old Man with Blurry Vision OS >OD
  • Anti-VEGF Clinical Trial Data (Diabetic Macular Edema)
  • Considerations in Choosing an Anti-VEGF Agent
Chapter 2: Anti-VEGF Injection Demonstration Video
Chapter 3: Proliferative Diabetic Retinopathy Without Diabetic Macular Edema
  • Case Study 2: 47-y-old Man With Decreasing Vision, OU; Large Floater OS
  • Anti-VEGF Clinical Trial Data (Diabetic Retinopathy)
Chapter 4: Tying It All Together: The Case for Early DR and DME Treatment
        •     Key Points
        •     Interdisciplinary Communication
        •     Patient Education
        •     Bilateral Anti-VEGF Injections
        •     Limitations of the Protocol T Study
        •     Letter to Healthcare Providers About Intravitreal Injections
        •     Patient Education Handout (DR and DME)
        •     Ranibizumab Prefilled Syringe Injection Demonstration Video

Accreditation Statement
Global Education Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This CME/CE activity complies with all requirements of the federal Physician Payment Sunshine Act. If a reportable event is associated with this activity, the accredited provider managing the program will provide the appropriate physician data to the Open Payments database.

Credit Designation Statement
Global Education Group designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For information about the accreditation of this program, please contact Global at (303) 395-1782 or inquire@globaleducationgroup.com.
Disclosure of Commercial Support
This activity is supported by an educational grant from Genentech, Inc.
Instructions for Participation
To receive a CME certificate of participation, participants must:
  • Follow instructions to register or log in with your professional information and complete the pretest.
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
  • A certificate of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.
For questions regarding CME credit, contact the Paradigm CME Department at (845) 398-5949.
There is no fee required for participation in this activity.

Hardware/Software Requirements
This certified CME activity is designed using HTML5 video.
Supported Browsers:
For Desktops (Windows/Mac)
Internet Explorer 9 or higher, Firefox 28 or higher, Safari 5.1 or higher, Google Chrome 31 or higher, Opera 21 or higher
For Tablets (iPad/Android/Surface)
iOS Safari 4 or higher, Android 2.3 or higher, IE Mobile 10 or higher
Technical Support: If you have any technical problems or playback issues email us at contactus@paradigmmc.com.
Disclosure and Resolution of Conflict of Interest
Global Education Group (Global) and Paradigm Medical Communications, LLC (Paradigm), require instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity.  All identified conflicts of interest are thoroughly vetted by Global and Paradigm for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. 
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Faculty or Presenter
Reported Financial Relationship
Nancy M. Holekamp, MD
Grant/Research Support: Alimera Sciences; Genentech, Inc;  Neurotech;
OHR Pharmaceutical
Retained Consultant: Allergan; Alimera Sciences; Genentech, Inc; Katalyst Surgical, LLC; Novartis; Regeneron; Shire
Honorarium: Allergan; Alimera Sciences; Genentech, Inc;  Regeneron
Stockholder: Kataylst Surgical, LLC
Patent: Katalyst Surgical, LLC
Arshad M. Khanani, MD, MA
Grant/Research Support: Aerpio; Allergan: Alcon: DigiSight Technologies Inc;
Genentech, Inc; Novartis; Ophthotech Corporation; ThromboGenics
Retained Consultant: Alimera Sciences, Allergan, Alcon, Genentech, Inc;
Speakers Bureau: Allergan; Genentech, Inc
The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Name of Planner or Manager
Reported Financial Relationship
Lindsay Brovansky
No financial relationships to disclose
Jamie Patrick
No financial relationship to disclose
Paradigm Medical Communications, LLC, staff members have no financial relationships to disclose.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global and Paradigm do not recommend the use of any agent outside of the labeled indications. 
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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