For Tammy Stewart, living with diabetes had always been frustrating. She watched as the condition ran through her family—her grandmother had type 1 diabetes, and both her sister and son are diabetic too. Tammy, herself, was diagnosed with type 2 diabetes 30 years ago.
“I did my labs and measured my blood sugar levels, but they were never really high,” she says. “When I started having vision changes, I was surprised. I kept thinking ‘why me?’”
The answer was time. Decades of moderately elevated blood sugar had gradually damaged the blood vessels in Tammy’s eyes, leading to vision problems.
Tammy had always been independent, helping her son to raise her grandson and caring for her husband through his cancer. As her vision worsened, everyday tasks became harder. When she visited Dr. Arghavan Almony, a retina specialist at Carolina Eye Associates, Tammy received a diagnosis she wasn’t expecting: diabetic macular edema.
Understanding DME
Diabetic macular edema, or DME, occurs when damaged blood vessels in the eye leak fluid, causing swelling in the macula—the part of the retina responsible for clear and focused vision. Symptoms include blurred vision, double vision, loss of contrast, and floaters. The result can impact day-to-day life, interfering with tasks like driving or reading.
Dr. Almony explains the urgency to treat DME with a simple analogy. “It’s like having a puddle of water on your wood floors. You want to dry it up as quickly as possible, because as the puddle sits there, it can start to stain the floor and cause the wood to rot,” she explains. “That’s what DME does to your vision—it doesn’t make you lose your sight overnight, but over time, the swelling causes damage to the cells in the back of the eye, which leads to vision loss.”
DME affects approximately 750,000 Americans and is a leading cause of vision loss among adults. Patients with diabetes can develop diabetic retinopathy (DR), which affects the eye and causes damage to retinal blood vessels. DME is a severe complication and form of DR and is specific to the macula (the center of the retina), where leakage causes swelling and vision loss. DME can develop at any stage of DR and may impact patients’ independence and quality of life.
Finding the Right Treatment Path
“I think most people who go to their retina specialist are scared out of their mind,” Dr. Almony says. “They come to me because they are worried that their world is going to change and they are going to go blind.”
When Tammy arrived for treatment in Dr. Almony’s office, she had significant swelling from DME in both eyes. Her left eye vision measured 20/100— this low vision made it very difficult for Tammy to see things far away, like street signs or faces. It also made it hard to read, to write checks, and to work on the computer. Her right eye vision was 20/30, but worsening.
“It is very concerning, when I see that much swelling, I know it is causing permanent damage to my patient’s eyes,” Dr. Almony recalls.
“As retina specialists, we used to have only one type of treatment for everybody,” notes Dr. Almony. “Thanks to recent advances, today, we have many options available for patients. The key is finding the personalized treatment that works best for each individual.”
Because of Tammy’s declining vision, Dr. Almony recommended exploring eye injections. She tried one injection but eventually sought alternative treatment. Dr. Almony enrolled Tammy in a patient access program for Vabysmo, an FDA-approved eye injection for DME (Please see Important Safety Information at the end of this article).
“I know people are scared of injections—but you do it because of the outcome,” Tammy notes. “And the outcome is worth it.”
A Turning Point
When Dr. Almony told Tammy the swelling in her eyes had decreased significantly after the first Vabysmo injection, she grabbed her specialist’s hand.
“You have to imagine,” Tammy says, her voice catching with emotion. “I had never heard any encouragement that the swelling was going down. Never.”
Most importantly, after continued treatment, Tammy is able to do activities that rely on her sight. She homeschools her grandson, reads lesson plans, and recently took her friends and family on a roadtrip to see the changing autumn leaves in the mountains.
“This really means a lot to me,” she says emotionally. “When I was first diagnosed with DME, I didn’t think I would ever be able to see the trees and the colors again.”
Treating DME
It’s important for patients with diabetes to schedule routine eye exams with an eyecare professional so that DME doesn’t go unnoticed. Patients with DME can benefit from controlling blood sugar levels, especially for managing and reducing symptoms, however, stronger results are often seen with adding medication. DME treatment is generally focused on reducing swelling and leakage in the retina. One class of treatment is an eye injection, which targets Vascular Endothelial Growth Factor (VEGF), which causes tiny, “leaky” blood vessels to grow under the retina. This leaking fluid and blood can cause swelling and make your vision blurry. VEGF-targeting medicine can soak up or block that excess VEGF to stop leaky blood vessels, help decrease swelling in the eye, and potentially help with vision.
Vabysmo (faricimab-svoa), an FDA-approved prescription treatment for DME, has two mechanisms of action that target not only VEGF but also angiopoietin-2 (Ang-2).
“What makes Vabysmo incredible and unique is that it is a dual-pathway treatment,” Dr. Almony explains. “Vabysmo is thought to block two pathways, specifically involving Ang-2 and VEGF, which are believed to contribute to vision loss by destabilizing blood vessels.”
By addressing multiple pathways simultaneously, Vabysmo aims to effectively treat DME. After four monthly doses, treatment schedules are personalized based on each patient’s response—Tammy’s injections were extended from every four weeks to every six weeks as her condition improved. With Vabysmo, patients have the chance of extending up to four months between injections. Staying on schedule with injections and talking to your eyecare doctor about what is expected will help protect your vision for the future.
Vabysmo is also approved to treat wet age-related macular degeneration (AMD) and macular edema following retinal vein occlusion (RVO). Injections like the one for Vabysmo can cause an eye infection; separation of layers of the retina; a temporary increase in pressure in the eye, and problems related to blood clots, such as heart attacks or strokes. They can also cause swelling inside the eye that in rare circumstances can cause blockage or narrowing of the blood vessels that carry blood to and from the retina. These are not all possible side effects. For more information, talk to your eye doctor and visit Vabysmo.com for the full Prescribing Information.
Moving Forward with Support
For people living with diabetes, regular eye exams aren’t optional—they’re essential. DME can develop even when blood sugar levels seem moderately controlled, and early detection makes a significant difference.
If you’re experiencing blurred vision, difficulty reading, or distorted central vision, talk with your healthcare provider and get your eyes screened. Don’t let fear of treatment prevent you from seeking help.
As Tammy learned, “Anybody who is scared, I want them to know that there is help. Don’t be afraid.”
The partnership between patient and doctor is crucial. Treatment requires consistency and patience, but as both Tammy and Dr. Almony discovered, the results can be life changing. Today, Tammy looks forward to many simple pleasures she once thought would be lost—including seeing her grandson’s smiling face.
“I’m thankful for this treatment,” Tammy says simply.
To learn how Vabysmo can help treat diabetic macular edema, visit vabysmo.com.
About Vabysmo® (faricimab-svoa)
Vabysmo is the first bispecific antibody approved for the eye. It targets and inhibits two signaling pathways linked to a number of vision-threatening retinal conditions by neutralizing angiopoietin-2 (Ang-2) and vascular endothelial growth factor-A (VEGF-A). While research is underway to better understand the role of the Ang-2 pathway in retinal disease, Ang-2 and VEGF-A are thought to contribute to vision loss by destabilizing blood vessels, which may cause new leaky blood vessels to form and increase inflammation. Thought to block pathways involving Ang-2 and VEGF-A, Vabysmo is designed to stabilize blood vessels.
Vabysmo U.S. Indications
Vabysmo (faricimab-svoa) is a prescription medicine given by injection into the eye, used to treat adults with neovascular (wet) age-related macular degeneration (AMD), diabetic macular edema (DME) and macular edema following retinal vein occlusion (RVO).
Important Safety Information
Contraindications
Vabysmo is contraindicated in patients who have an infection in or around their eye, have active swelling around their eye that may include pain and redness, or are allergic to Vabysmo or any of the ingredients in Vabysmo.
Warnings and Precautions
- Injections like the one for Vabysmo can cause an eye infection (endophthalmitis) or separation of layers of the retina (retinal detachment). Patients should seek medical care if they experience increasing eye pain, vision loss, sensitivity to light, or redness in the white of the eye.
- Vabysmo may cause a temporary increase in pressure in the eye (intraocular pressure), which occurs 60 minutes after the injection.
- Although not common, Vabysmo patients have had serious, sometimes fatal, problems related to blood clots, such as heart attacks or strokes (thromboembolic events). In clinical studies for wet AMD during the first year, 7 out of 664 patients treated with Vabysmo reported such an event. In DME studies from baseline to week 100, 64 out of 1,262 patients treated with Vabysmo reported such an event. In clinical studies for RVO during 6 months, 7 out of 641 patients treated with Vabysmo reported such an event.
- Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of Vabysmo. Healthcare providers should discontinue treatment with Vabysmo in patients who develop these events. Patients should be instructed to report any change in vision without delay.
Adverse Reactions
The most common adverse reactions (≥5%) reported in patients receiving Vabysmo were cataract (15%) and blood on the white of the eye (conjunctival hemorrhage, 8%). These are not all the possible side effects of Vabysmo.
Pregnancy, Lactation, Females and Males of Reproductive Potential
- Based on how Vabysmo interacts with your body, there may be a potential risk to an unborn baby. Patients should use birth control before their first injection, during their treatment with Vabysmo, and for 3 months after their last dose of Vabysmo.
- It is not known if Vabysmo passes into breast milk. Patients should talk to their healthcare provider about the best way to feed their baby if they receive Vabysmo.
Patients may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch. Patients may also report side effects to Genentech at (888) 835-2555.
Please see additional Important Safety Information in the full Vabysmo Prescribing Information or visit https://www.Vabysmo.com.
