Therapeutic Approaches for DME Outlined
With the incidence of diabetes continuing to rise and showing no signs of abating, managing diabetic macular edema (DME) will become increasingly important for anterior segment surgeons, noted Michael W. Stewart, MD, during the American Society of Cataract and Refractive Surgery’s 2018 annual meeting in Washington, DC. The professor and chairman of the Department of Ophthalmology at Mayo Clinic Florida reviewed preventive, early detection, and management tips.
The American Diabetes Association recommends yearly dilated eye exams in patients with type 2 diabetes at the time they are diagnosed, and in those with type 1 diabetes 5 years after they are diagnosed. However, evidence suggests that only 35% of people with diabetes receive an eye exam in any given year, and less than half that number are examined 2 years in a row.
With regards to therapy for diabetic macular edema:
- Laser photocoagulation is preferred for non-center involving DME; it is considered second or third line for center involving disease.
- Anti-vascular endothelial growth factor (VEGF) injections are considered first-line treatment for center involving DME.
- All of the anti-VEGF medications have been shown to work equally in eyes with visual acuity of 20/40 or better.
- Aflibercept appears to be best for eyes that are 20/50 or worse.
- Aggressive therapy typically produces the best visual results.
Stewart M. Data-Driven management of diabetic macular edema for comprehensive ophthalmologists. Talk presented at: 2018 ASCRS-ASOA Annual Meeting; April 13-17, 2018; Washington, DC.