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Role of intravitreal steroids in DME management should be reevaluated

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A new meta-analysis compared the efficacy and safety of intravitreal steroids and intravitreal anti-vascular endothelial growth factor (VEGF) injections for the treatment of diabetic macular edema (DME).

In the study, researchers analyzed 14 randomized clinical trials (827 eyes). No significant difference in BCVA outcomes between those treated with an anti-VEGF agent or steroids were found at 3 months, 6 months, 12 months, and final follow-up.

At 3 months, 6 months, and final follow-up after treatment with steroids retinal thickness was significantly lower, but there was no significant difference at 12 months.

A higher incidence of IOP-related adverse events was noted with intravitreal steroid use but there was no significant difference between steroids and anti-VEGF treatment for other adverse events.

The authors noted that the certainty of evidence in this analysis ranged from low to moderate and was limited by heterogeneity.

Patil NS, Mihalache A, Hatamnejad A, et al. Intravitreal steroids compared to anti-vascular endothelial growth factor treatment for diabetic macular edema: a meta-analysis. Ophthalmol Retina. 2022;S2468-6530(22)00494-8. doi: 10.1016/j.oret.2022.10.008. Epub ahead of print. PMID: 36272716.