Published online Oct 15, 2013. doi: 10.4239/wjd.v4.i5.165
Revised: July 21, 2013
Accepted: September 18, 2013
Published online: October 15, 2013
Diabetes is a serious chronic condition, which increase the risk of cardiovascular diseases, kidney failure and nerve damage leading to amputation. Furthermore the ocular complications include diabetic macular edema, is the leading cause of blindness among adults in the industrialized countries. Today, blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy. The treatment should include an optimized control of glycemia, arterial tension, lipids and renal status. The photocoagulation laser is currently restricted to focal macular edema in some countries, but due the high cost of intravitreal drugs, the use of laser treatment for focal and diffuse diabetic macular edema (DME), can be valid as gold standard in many countries. The intravitreal anti vascular endothelial growth factor drugs (ranibizumab and bevacizumab), are indicated in the treatment of all types of DME, but the correct protocol for administration should be defined for the different Retina Scientific Societies. The corticosteroids for diffuse DME, has a place in pseudophakic patients, but its complications restricted the use of these drugs for some patients. Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients.
Core tip: Diabetic macular edema is the leading causes of decreased visual acuity in diabetic patients, being the most important blindness causes in young adult people. New treatments have been developed in the last years, intravitreal anti-vascular endothelial growth factor drugs, corticoid intravitreal implants or injections, but the laser photocoagulation being the gold standard of diabetic macular edema treatment. The following manuscript tries to clarify the current status of diabetic macular edema treatment.