Published online Apr 15, 2021. doi: 10.4239/wjd.v12.i4.437
Peer-review started: January 13, 2021
First decision: February 12, 2021
Revised: February 23, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: April 15, 2021
Core Tip: Progress in optical coherence tomography technology allowed the identification of new pathogenic pathways in diabetic macular edema (DME) involving the outer retina and underlying choroid. The presence of fluid in the subretinal space is suggestive for the alteration of the outer blood retinal barrier and responds better to intravitreal triamcinolone as compared to anti- vascular endothelial growth factor. The disruption of external limiting membrane (ELM) is associated with visual impairment being a predictor of poor outcomes following the treatment with triamcinolone. The integrity of ELM and of the inner segment/outer segment line was found to correlate positively with best corrected visual acuity in DME.