Diabetic retinopathy is damage to the blood vessels of the retina caused by prolonged high blood sugar and is the leading cause of blindness in working-age adults. It progresses silently through stages, and preventing vision loss depends on early detection and timely treatment.
What's actually going on in research
Anti-VEGF injections remain the gold standard for vision-threatening diabetic macular edema, and longer-acting and more potent versions are reducing injection frequency. Faricimab, which targets both VEGF and Ang-2, allows quarterly dosing in many patients and is being tested for preventing progression to proliferative disease. GLP-1 agonists are being studied for whether their metabolic effects reduce retinopathy progression beyond their blood sugar benefits.
Longer-acting anti-VEGF
Faricimab (targeting VEGF and Ang-2) and port delivery systems reduce injection burden to quarterly or less. Trials are testing them in diabetic macular edema and proliferative retinopathy.
GLP-1 effects on retinopathy
GLP-1 agonists reduce diabetes complications broadly; dedicated trials are measuring whether semaglutide and tirzepatide slow diabetic retinopathy progression independent of blood sugar reduction.
Neuroprotective approaches
Brimonidine implants and other drugs targeting the neurodegeneration that occurs early in diabetic retinopathy — before vascular damage is visible — are in trials to intercept the disease earlier.
What to know before you search
Eligibility depends on retinopathy severity grade, presence of diabetic macular edema, visual acuity, and prior anti-VEGF or laser treatment history.
What types of trials are currently open
- Anti-VEGF trials — Testing new anti-VEGF drugs, dosing intervals, and delivery methods for diabetic macular edema.
- Prevention trials — Evaluating metabolic interventions and laser therapy to prevent progression from non-proliferative to proliferative disease.
- Drug trials — Testing GLP-1 agonists, anti-inflammatory agents, and neuroprotective drugs for retinopathy progression.
- Screening trials — Validating AI-assisted retinal imaging for diabetic retinopathy screening in primary care.
- Surgical trials — Evaluating vitrectomy techniques for advanced proliferative retinopathy and traction retinal detachment.
Recently added Diabetic Retinopathy trials
Defining Retinal Structures Using Hyperspectral Retinal Imaging
This study evaluates hyperspectral retinal imaging as a novel, non-invasive imaging technique to characterise retinal and optic nerve structures in healthy individuals and patients with eye disease. Hyperspectral imaging captures retinal data across multiple wavelengths to generate detailed spectral information that may reveal features not visible with conventional retinal photography. Approximately 1000 participants will undergo multi-modal ophthalmic imaging in Melbourne, Australia, including hyperspectral imaging, OCT, fundus photography, and related tests. The study aims to compare hyperspectral imaging with standard imaging methods and assess its ability to identify retinal biomarkers associated with diseases such as diabetic retinopathy, glaucoma, and age-related macular degeneration.
Serum Cholinesterases, Paraoxonase, and Cardiovascular Risk After Intravitreal Bevacizumab
Bevacizumab, an anti-VEGF (vascular endothelial growth factor) agent used in the treatment of diabetic retinopathy and macular edema associated with retinal vein occlusion, is commonly administered in ophthalmology clinics through intravitreal injection. The systemic use of bevacizumab has been associated with serious conditions such as thromboembolism and bleeding. Although intravitreal bevacizumab is administered in smaller amounts and has limited systemic circulation, it requires repeated injections over a long period. These long-term intravitreal anti-VEGF therapies may lead to adverse outcomes, particularly thromboembolism, due to systemic inhibition of VEGF. However, limited information is available regarding the potential effects of this treatment on the systemic and cardiovascular systems. To evaluate this risk, the study aims to assess changes in the activities of paraoxonase 1 (PON1), acetylcholinesterase (AChE), and butyrylcholinesterase (BChE), which are closely associated with lipid metabolism, coronary artery disease, and atherosclerosis. These enzymes are known biomarkers of cardiovascular health and play significant roles in protection against oxidative stress and inflammation. For this purpose, a case-control study is planned. Serum BChE and PON1 activities, as well as triglyceride (TG)/high-density lipoprotein (HDL) and TG/glucose ratios, will be determined in patients receiving repeated intravitreal bevacizumab injections and in control groups, and cardiovascular disease risk will be assessed. This study may help us better understand the safety profile of this treatment by revealing the effects of bevacizumab on serum enzyme activities and cardiovascular risk factors. These findings could contribute to optimizing treatment strategies in clinical practice.
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