Abstract
Treatment for diabetic macular edema (DME) is continuously evolving with the advent of pharmacologic therapies. Focal laser photocoagulation remains the historical standard of care; however, a new wave of studies is rapidly emerging that shows the benefit of intravitreal antivascular endothelial growth factor medications and corticosteroids. The goal of this review is to compare the various treatment options for DME, and include data from the most recent clinical trials of therapies for this complex condition.
Highlights
Diabetic macular edema (DME) is a primary cause of visual loss in diabetic patients in the working age population of the US [1, 2]
In the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), the 10-year rate of developing DME was 20.1% in patients with type 1 diabetes and, in patients with type 2 diabetes, it was 25.4% for those treated with insulin, and 13.9% for those not treated with insulin [4]
Systemic risk factors associated with DME include age, male gender, systolic blood pressure, hyperlipidemia, proteinuria, insulin use, diuretic use, a longer duration of diabetes, higher glycosylated hemoglobin, and pan-retinal photocoagulation (PRP) [5,6,7,8]
Summary
Diabetic macular edema (DME) is a primary cause of visual loss in diabetic patients in the working age population of the US [1, 2]. The Early Treatment Diabetic Retinopathy Study (ETDRS) defined macular edema as the thickening of the retina and/or hard exudates within 500 lm of the center of the macula [3]. In the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), the 10-year rate of developing DME was 20.1% in patients with type 1 diabetes and, in patients with type 2 diabetes, it was 25.4% for those treated with insulin, and 13.9% for those not treated with insulin [4]. The goal of this review is to compare the various treatment options for DME, and include data from the most recent clinical trials of therapies for this complex condition
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