CRU 2025: The latest in treatments for DR, nAMD, and GA

Advances in retinal treatments, emerging technologies, and clinical trial insights were discussed by Rachelle Lin, OD, MS, FAAO, and Quan Đông Nguyễn, MD, MSc, during their “Retina Roundup” presentation given at CRU 2025, which was held from March 28-30 in Napa, California. The duo discussed new and proven treatment options for neovascular age-related macular degeneration (nAMD), geographic atrophy (GA), and diabetic retinopathy (DR).¹

“We have more treatments than ever before, and have whole new classes of drugs that are being looked at as treatments for these conditions,” Lin said.

In terms of diabetic macular edema (DME) treatments, a variety of anti-VEGFs, corticosteroids, and grid/focal laser photocoagulation are available. Newer anti-VEGF treatments include brolucizumab, faricimab, and aflibercept 8 mg. Notably, a recent update for faricimab is the FDA approval for a single-dose prefilled syringe for treatment of nAMD, DME, and macular edema following retinal vein occlusion (RVO). Future treatments that Nguyễn highlighted were oral medications such as APX3330, a small-molecule Ref-1 inhibitor for the treatment of moderate to severe non-proliferative diabetic retinopathy (NPDR).¹

“Our goal is to make sure that it does not progress to NPDR or to high-risk NPDR, so the question would be, ‘What would be a treatment that will be practical for patients?’” Nguyễn said. “We know having patients come in monthly or in 2 months for injections or something like this is not very practical and has not really worked.”

Treatment considerations can include earlier treatment, a patient’s ability to return for injections, if a VEGF therapy should be changed, and the use of combination therapy. Additionally, faricimab and aflibercept 8 mg allow for increased intervals between injections with noninferior outcomes for DME, meaning fewer appointments and less burden on patients.¹

For GA, an MD would consider treating a patient with either pegcetacoplan or avacincaptad pegol, or contraindications. Future treatments are anticipated down the pipeline in gene therapy, optogenetics, and small molecules.¹

Ultimately, Lin’s clinical takeaways for AMD are that the diagnosed population will continue growing, with the condition having a significant impact on the daily lives of patients. Patient expectations should be managed, as dry AMD treatments are meant to slow GA and not to restore vision. Referring patients with GA and nAMD for evaluation and treatment is also crucial to proper patient care.¹

“If we look at AMD as a whole, we know the AMD population will just continue growing with our baby boomer population,” Lin said. “We're seeing more and more of them in our retina clinics with ophthalmologists getting injections. We're seeing more and more of them in our low treatment clinics. So we need to find a way to treat more of these patients effectively, and hopefully some of these treatments that allow us to have longer stretches between dosing will also help with compliance and also help with just taking some of that load off of our overworked retina doctors.”

With the recent FDA approval of revakinagene taroretcel for the treatment of macular telangiectasia type 2 (MacTel), Lin said she wants to see more referrals from optometrists to ophthalmologists in order to preserve sight for more patients. She added that MacTel does have effects on vision, including complaints of blur, metamorphopsia, and central or paracentral scotoma, and difficulty reading; however, visual acuity generally remains stable and rarely progresses to worse than 20/200.¹

Reference:

1. Lin R, Nguyễn QD. Retina Roundup. CRU 2025 presentation. March 28, 2025. Napa, California.