CRU 2025: A retinal roundup with Dr. Quan Đông Nguyễn

At the 2025 CRU meeting in Napa, California, Quan Đông Nguyễn, MD, MSc discussed recent developments in retinal diseases, focusing on diabetic retinopathy, macular edema, geographic atrophy, and neovascular age-related macular degeneration (nAMD). He highlighted the availability of new medical therapies and the benefits and risks of anti-complement therapies for geographic atrophy. The discussion also covered the ineffectiveness of adding VEGF-C and -D blockers in neovascular AMD treatments. The session emphasized early treatment, the importance of collaboration between ophthalmology and optometry, and the potential of growth factor therapies like ciliary neurotrophic factor for macular telangiectasia.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Hi, I'm Quan Đông Nguyễn, currently professor of ophthalmology, Medicine and Pediatrics at the Byers Eye Institute and at Stanford University School of Medicine in Palo Alto. Certainly, it's great pleasure to be back here at the 2025 CRU meeting here in Napa. Yesterday, we were discussing about the various developments and investments in the field of retina, especially medical retina aspect as well as inherited retinal disease. So I had a wonderful time sharing with our colleagues some of the developments we have. The session covered 4 different parts, starting out with diabetic retinopathy, diabetic macular edema, then followed by geographic atrophy, and followed by neovascular AMD, and finished up with a session on treatment of different aspect of the disease and the treatment, the last aspect we covered, was macular telangiectasia. So during that 1-hour discussion, we went over many different aspects. Certainly, we talked about some of the latest developments, availability of medical therapy in medical retina, for example, with the availability of flotetuzumab, with the availability of the high dose of aflibercept, 8 milligram. Then we talked about how we can use them, when to apply them, when to switch, when to do certain things.

Subsequently, we talked about geographic atrophy. Currently we have 2 different availability drug that we use for treatment of geographic atrophy: anti-complement 3 and anti-commitment 5. And so we discussed about the potential goods and benefits of both of them, knowing that even though they do not stop the growth of the disease, of the geographic atrophy, but they certainly can slow down. And so we talk about the risk and benefit for that.

Then we move over to neovascular AMD, where we were able to look at different regimen, different study. Again, based on the development of that, we learned that it is very important to treat, certainly using anti-VEGF therapy, but also perhaps to consider other aspects. We learned that the addition of blockage of VEGF-C and D may not make a difference, given the result of the recent costudy that failed to show that addition of anti-VEGF-C and D make any difference for that in that aspect. So we learned about upcoming trials that may be helping to reset the goal for our patient with retinal vascular diseases like diabetic retinopathy and macular degeneration.

Then we all finished the session about treatment for macular telangiectasia, showing that how the ciliary growth factor has been able to improve of that concept. So the CNTF treatment, ciliary neurotrophic factor, have been very helpful, and the trial positive, and it's recently been approved. So we look forward on perhaps consider managing outpatient with that condition with the latest treatment. So overall, the session was quite exciting. I was very pleased to be able to share our knowledge with our colleagues in both ophthalmology, as well teaching, educating some our colleague in optometry as well, some of the latest development we have.

One of the concepts that come out recently is that disease should be treated early and not waiting for end stages. So I think the collaboration between the 2 fields of ophthalmology and optometry is extremely important. Certainly, there's limited number of ophthalmologists, especially retina specialists, so therefore, many of our patients are being evaluated locally in different small cities, for example, by our colleagues in optometry. It would be very good to alert the patient, alert yourself also too, that disease can come or can reoccur unexpectedly. And we have learned from many of these trials that it is better to treat early and treat appropriately. So delay treatment may not be good, so it's very good that we could detect early and perhaps the optometrists can then send to the appropriate colleagues in retina, for example, to help out.