Abstract
Diabetic macular edema (DME) is the leading cause of vision impairment in diabetic patients and is a major cause of blindness worldwide in the working age adults. The pathogenesis is still not well understood. Vascular endothelial growth factor (VEGF) is known to play a major role in the pathogenesis of DME. Currently, intravitreal injection of anti-VEGF agents remains as the first-line therapy in DME treatment due to the favorable anatomic and functional outcomes. Despite this, around 30% of the patients have persistent DME even after multiple anti-VEGF injections. This suggests that various other pathogenetic mechanisms such as inflammatory marker upregulation and oxidative stress are in play, so there is a need to look into intravitreal steroids and other modalities to tackle DME. Multimodal imaging using Optical coherence tomography (OCT)/OCT-angiography (OCT-A)/Fluocinolone acetonide (FA) gives insights into the DME subtypes and biomarkers which guide the diagnosis, optimal treatment, and monitoring. The present review aims to summarize the current understanding of DME and explore the modalities for personalized treatment protocols in patients with DME.
Published Version
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