ReviewClinical ophthalmology (Auckland, N.Z.)2021
Guidelines for the Management of Center-Involving Diabetic Macular Edema: Treatment Options and Patient Monitorization.
Review in Clinical ophthalmology (Auckland, N.Z.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Aflibercept for long-term treatment of diabetic macular edema and proliferative diabetic retinopathy: a meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Beyond Vision: Prospective Real-World Evaluation of Quality-of-Life and Caregiver Burden in Diabetic Macular Edema Treated with Fluocinolone Acetonide (IluvienOphthalmology and therapy · 2026Article
- Nonadherence to anti-VEGF intravitreal injections in patients with diabetic macular edema : The names of the authors.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Review
- Article
- Assessing variation in US payer coverage of anti-vascular endothelial growth factor therapies for the treatment of age-related macular degeneration, diabetic retinopathy, and diabetic macular edema.Journal of managed care & specialty pharmacy · 2025Article
- Global trends and hotspots of inflammation in diabetic retinopathy: a literature review and bibliometric analysis.Frontiers in medicine · 2025Review
- Patient-Centered Economic Burden of Diabetic Macular Edema: Retrospective Cohort Study.JMIR public health and surveillance · 2024Article
- Burden of Disease Study of Patients with Diabetic Macular Oedema in Spain.Ophthalmology and therapy · 2024Article
- Aflibercept Off-Target Effects in Diabetic Macular Edema: An In Silico Modeling Approach.International journal of molecular sciences · 2024Article
- Time to fellow eye involvement in patients with unilateral diabetic macular oedema.Eye (London, England) · 2023Article
- Pharmacotherapy and Nutritional Supplements for Neovascular Eye Diseases.Medicina (Kaunas, Lithuania) · 2023Review
- Drug-Repurposing Strategy for Dimethyl Fumarate.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Distance and near vision changes after intravitreal anti-vascular endothelial growth factor injection in eyes with center-involving diabetic macular edema.Indian journal of ophthalmology · 2023Article
- Assessment of Aptamer as a Potential Drug Targeted Delivery for Retinal Angiogenesis Inhibition.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Multivendor fully automatic uncertainty management approaches for the intuitive representation of DME fluid accumulations in OCT images.Medical & biological engineering & computing · 2023Article
- Mid-term safety and effectiveness of macular peeling one month after intravitreal dexamethasone implant for tractional diabetic macular edema.Scientific reports · 2023Article
- Vitreous Humor Proteome: Targeting Oxidative Stress, Inflammation, and Neurodegeneration in Vitreoretinal Diseases.Antioxidants (Basel, Switzerland) · 2022Review
- Prediction of Visual Acuity after anti-VEGF Therapy in Diabetic Macular Edema by Machine Learning.Journal of diabetes research · 2022Article
- Microvascular Changes After Conbercept Intravitreal Injection of PDR With or Without Center-Involved Diabetic Macular Edema Analyzed by OCTA.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diabetic macular edema (DME) is the main cause of visual impairment associated with diabetic retinopathy (DR) and macular laser, during approximately three decades, and was the single treatment option. More recently, intravitreous injections of anti-angiogenics and corticosteroids modified the treatment paradigm associated with significant vision improvements. Nevertheless, not all patients respond satisfactorily to anti-VEGF or corticosteroid injections, so an adequate treatment choice and a prompt switch in therapeutic class is recommended. Several algorithms and guidelines have been proposed for treating center involving DME to improve patients' vision and quality of life. However, in Portugal, such guidelines are lacking. The present review aimed to provide guidelines for the treatment options and patient monitorization in the management of center-involving DME. We recommend anti-vascular endothelial growth factor (VEGF) as first-line therapy after a clinical evaluation accompanied by a rigorous metabolic control. Depending on the response obtained after 3-6 monthly intravitreal injections we suggest switching outside the class in case of a non-responder, maintaining the anti-VEGF-therapy in responders to anti-angiogenics. The treatment regimen for Dexamethasone intravitreal implant (DEXii) should be pro-re-nata with bi-monthly or quarterly monitoring visits (with a scheduled visit at 6-8 weeks after DEXii for intraocular pressure control). If a patient does not respond to DEXii, switch again to anti-VEGF therapy, combine therapies, or re-evaluate patients diagnose. There is a resilient need to understand the disease, its treatments, regimens available, and convenience for all involved to propose an adequate algorithm for the treatment of diabetic retinopathy (DR) and DME in an individualized regimen. Further understanding of the contributing factors to the development and progression of DR should bring new drug discoveries for more effective and better-tolerated treatments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.