Current approaches to the treatment of diabetic macular edema. A literature review

• Main Author: E. V. Bobykin
• Format: Article
• Language: Russian
• Published: Publishing house "Ophthalmology" 2019-04-01
• Series: Офтальмохирургия
• Subjects: diabetic macular edema; retinal laser coagulation; antivegf therapy; aflibercept; ranibizumab; dexamethasone
• Online Access: https://www.ophthalmosurgery.ru/jour/article/view/482

Despite advances in treatment of diabetes eye complications, diabetic macular edema (DME) remains a common cause of vision loss. Until recently, DME treatment was based on a combination of careful metabolic control and the use of laser photocoagulation. This approach helped to stabilize, but not improve visual function. Also, laser coagulation, despite its effectiveness, is considered as destructive and associated with complications method of treatment. Limited treatment options of diabetic retinopathy led to active research of drugs that can affect complex pathogenetic mechanisms of this disease. The current global experience in treatment allows us to state a paradigm shift in the treatment of DME: antiangiogenic therapy (intravitreal injections of vascular endothelial growth factor-VEGF-inhibitors) is now established as first line therapy. Its effectiveness and safety allowed it to sideline retinal laser coagulation, steroid therapy and vitreoretinal surgery. The article describes the current evidence base for use of anti-VEGF therapy, laser treatment and intravitreal steroids in DME. Article provides data on comparative efficacy and possibility of joint use of various methods of treatment as well as comparison of main anti-angiogenic agents and their treatment regimens.