The scientific community is more motivated than ever to fight back. From FDA- approved artificial intelligence that quickly screens patients to gene therapies targeting the molecular causes of the disease, the landscape of diabetic retinopathy

treatment is evolving. Lions Saving Sight believes everyone, regardless of income, deserves access to these advances. This commitment begins with raising awareness.

The Scale of the Problem: A Global Crisis in Plain Sight

A 2024 review in Frontiers in Endocrinology estimates that diabetic retinopathy affects 103 million people worldwide. The number is expected to increase as the global diabetes epidemic continues to grow. In the United States, nearly 8 million adults may have DR. Many cases go unnoticed until significant, often irreversible, damage occurs.

Nearly half of all Americans with diabetes have never undergone a dilated eye exam, which is a crucial test for detecting diabetic retinopathy before it causes permanent vision loss. The disease develops in two main stages. Non-proliferative diabetic retinopathy (NPDR) is the first stage, characterized by weakened blood vessel walls,tiny hemorrhages, and early fluid leaks. Many patients do not notice any vision changes during this phase, making it especially dangerous. If left untreated, NPDR can progress to proliferative diabetic retinopathy (PDR). In this later stage, abnormal new blood vessels grow in the eye, bleed easily, and can lead to scar tissue and retinal detachment, potentially causing blindness.

By the numbers:

103 million people affected by DR worldwide (Frontiers in Endocrinology, 2024)

Over 160 million projected cases worldwide by 2045.

90% of DR-related blindness can be prevented through early detection and treatment.

The AI Revolution: Catching What the Eye Cannot See

Perhaps no recent development has sparked more excitement or shown more real- world impact than the integration of artificial intelligence into DR screening. The effects on accessibility and early detection are significant.

Emerging Treatments: The Next Generation of Therapies

The research process for diabetic retinopathy is now more extensive and varied than ever, with many Phase 2 and Phase 3 trials currently underway.

Next-Generation Anti-VEGF and Longer-Acting Formulations

Researchers are developing implantable port delivery systems for continuous drug release and combination therapies targeting VEGF and other disease pathways, aiming to extend treatment intervals from weeks to months and significantly reduce patient burden.

Oral and Topical Therapies

Researchers are exploring both oral and topical treatments. Fenofibrate, an oral medication, is in advanced Phase 3 trials for its potential to slow DR progression. Eye drops with integrin inhibitors are being studied for early-stage disease and may

provide a self-administered home treatment.

Gene Therapy

A 2024 review in Frontiers in Endocrinology highlights AAV-mediated gene therapy as a significant advancement. This method delivers anti-angiogenic genes to retinal cells, which then produce VEGF-blocking proteins. If successful, gene therapy could transform DR from a chronic, injection-dependent condition into one that can be managed with a single procedure.

Stem Cell Therapies

Research published in the Journal of Clinical Medicine (2025) reports promising early results using adipose-derived and bone marrow mesenchymal stem cells to reduce inflammation, limit abnormal vessel growth, and support retinal cell survival. This

approach has the potential not only to halt DR but also to repair already damaged retinal tissue.

Nanotechnology, CRISPR, and Personalized Medicine

Nanotechnology-based drug delivery systems designed to penetrate ocular barriers and release medication exactly where needed are progressing toward clinical use. Meanwhile, CRISPR-Cas9 gene-editing tools are being investigated to make precise corrections to genetic sequences that contribute to DR susceptibility. This holds truly transformative long-term potential.

The Access Gap: When Innovation Doesn't Reach Everyone

The advances described here represent the forefront of a true revolution. However, for millions of the most vulnerable patients—those with low incomes, inadequate insurance, or limited access to specialty care—these breakthroughs remain out of reach. African Americans are diagnosed with DR at disproportionately high rates and face worse outcomes mainly because of barriers to consistent eye care. The same obstacles affect Hispanic and Latino communities as well as low-income rural populations.

Technological advances change what is possible. Access determines who benefits. Lions Saving Sight focuses on closing this gap.

Lions Saving Sight: Where Science Meets Compassion

At Lions Saving Sight, our mission is to ensure that people who cannot afford sight- saving care still receive it. As the landscape of diabetic retinopathy treatment evolves, we serve as the bridge between available medical options and what vulnerable patients can access through our referral network, relationships with trusted eye surgeons, and a comprehensive intake and support process.

What You Can Do

• If you have diabetes, get a complete dilated eye exam at least once a year, even if your vision appears normal.

• If you know someone with unmanaged diabetes or untreated vision problems, refer them to Lions Saving Sight.

• If you are a healthcare provider, think about how AI-assisted screening can be incorporated to detect DR earlier.

• Donate to Lions Saving Sight. Every dollar directly funds sight-saving surgeries for those unable to afford treatment.

The science is on our side. Access is the final frontier. Help us close the gap.

Lions Saving Sight | Restoring Sight, Transforming Lives

www.lionssavingsight.org | Donate Today to Fund Sight-Saving Surgeries