Intravitreal Therapy for Diabetic Macular Edema: An Update
Diabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2021/6654168 |
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| author | Claudio Furino Francesco Boscia Michele Reibaldi Giovanni Alessio |
| author_facet | Claudio Furino Francesco Boscia Michele Reibaldi Giovanni Alessio |
| author_sort | Claudio Furino |
| collection | DOAJ |
| description | Diabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular endothelial growth factor inhibitors or corticosteroids therapies), and surgical removal are currently available. Although laser has been considered as the gold standard for many years, over the past several years vascular endothelial growth factor inhibitors (anti-VEGFs) have become first-line therapy. However, many patients do not adequately respond to them. With the development of sustained-release corticosteroid devices, steroids have gained a presence in the management of the DME. We review and update the role of anti-VEGF and intravitreal sustained-release corticosteroid management of DME. According to the currently available scientific evidence, the choice of one anti-VEGF over another critically depends on the baseline best-corrected visual acuity (BCVA). While aflibercept may be the drug of choice in low baseline BCVA, the three anti-VEGFs (bevacizumab, ranibizumab, and aflibercept) provided similar functional outcomes when the baseline BCVA was higher. DEX implants are a valuable option for treating DME, although they are usually seen as a second choice, particularly in those eyes that have an insufficient response to anti-VEGF. The new evidence suggested that, in eyes that did not adequately respond to anti-VEGF, switching to a DEX implant at the time to 3 monthly anti-VEGF injections provided better functional outcomes. |
| format | Article |
| id | doaj-art-0395c38051e54dfe878f93f590e196c0 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-0395c38051e54dfe878f93f590e196c02025-02-03T01:05:26ZengWileyJournal of Ophthalmology2090-004X2090-00582021-01-01202110.1155/2021/66541686654168Intravitreal Therapy for Diabetic Macular Edema: An UpdateClaudio Furino0Francesco Boscia1Michele Reibaldi2Giovanni Alessio3Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Azienda Ospedaliero-Universitaria Policlinico Bari, Bari, ItalyDepartment of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Azienda Ospedaliero-Universitaria Policlinico Bari, Bari, ItalyDepartment of Surgical Sciences, Eye Clinic, University of Torino, Torino, ItalyDepartment of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Azienda Ospedaliero-Universitaria Policlinico Bari, Bari, ItalyDiabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular endothelial growth factor inhibitors or corticosteroids therapies), and surgical removal are currently available. Although laser has been considered as the gold standard for many years, over the past several years vascular endothelial growth factor inhibitors (anti-VEGFs) have become first-line therapy. However, many patients do not adequately respond to them. With the development of sustained-release corticosteroid devices, steroids have gained a presence in the management of the DME. We review and update the role of anti-VEGF and intravitreal sustained-release corticosteroid management of DME. According to the currently available scientific evidence, the choice of one anti-VEGF over another critically depends on the baseline best-corrected visual acuity (BCVA). While aflibercept may be the drug of choice in low baseline BCVA, the three anti-VEGFs (bevacizumab, ranibizumab, and aflibercept) provided similar functional outcomes when the baseline BCVA was higher. DEX implants are a valuable option for treating DME, although they are usually seen as a second choice, particularly in those eyes that have an insufficient response to anti-VEGF. The new evidence suggested that, in eyes that did not adequately respond to anti-VEGF, switching to a DEX implant at the time to 3 monthly anti-VEGF injections provided better functional outcomes.http://dx.doi.org/10.1155/2021/6654168 |
| spellingShingle | Claudio Furino Francesco Boscia Michele Reibaldi Giovanni Alessio Intravitreal Therapy for Diabetic Macular Edema: An Update Journal of Ophthalmology |
| title | Intravitreal Therapy for Diabetic Macular Edema: An Update |
| title_full | Intravitreal Therapy for Diabetic Macular Edema: An Update |
| title_fullStr | Intravitreal Therapy for Diabetic Macular Edema: An Update |
| title_full_unstemmed | Intravitreal Therapy for Diabetic Macular Edema: An Update |
| title_short | Intravitreal Therapy for Diabetic Macular Edema: An Update |
| title_sort | intravitreal therapy for diabetic macular edema an update |
| url | http://dx.doi.org/10.1155/2021/6654168 |
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