Management of Diabetic Macular Edema in Current Clinical Practice: A Review

Abstract

Diabetes is the most common cause of blindness in working age adults in developed countries. The last decade has seen major advances in the management of diabetic macular edema (DME), with the emergence of numerous therapeutic alternatives whose role is not yet fully defined. In this context, we present an updated review and guide to the clinical management of DME. In this review we discuss the role of complementary studies suggesting different courses of action based on the clinical, angiographic and tomographic classification of DME, and we highlight the role of laser therapy in the treatment of focal and multifocal macular edema. In cases of resistant or diffuse DME with central involvement, we propose the combined use of antiangiogenic drugs or intravitreal corticosteroids followed by laser. In patients with DME with a tractional component and functional repercussion, a surgical approach may be indicated.