title: What have we learnt about the management of diabetic macular edema in the antivascular endothelial growth factor and corticosteroid era?
abstract: OBJECTIVE
  To summarize the outcomes of the use of antivascular endothelial growth factor (anti-VEGF) agents and corticosteroids on the treatment paradigm for diabetic macular edema (DME).
  
  
  RESULTS
  Favorable efficacy data along with acceptable long-term safety results of anti-VEGF agents have made them the standard first-line therapy in the management of DME. Level I evidence from large, multicenter clinical trials has established the beneficial role of anti-VEGF agents and intravitreal steroids. In addition, the role of anti-VEGF agents in the treatment of diabetic retinopathy has also been recently recognized. However, concerns such as suboptimal response, VEGF resistance, and long-term effects on retinal layers and vasculature have also been highlighted recently.
  
  
  CONCLUSIONS
  The use of anti-VEGF agents and corticosteroids has revolutionized the management of DME. Despite the advantages including ease of administration, low incidence of adverse events, and concomitant improvement in retinopathy status, limitations of this therapeutic approach have been recognized. The current review will focus on the lessons learnt in the management of DME in the anti-VEGF and steroid era.
authors.affiliation: Ocular Imaging Research and Reading Center (OIRRC), Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Agarwal
authors.forename: Salman
authors.initials: S
authors.lastname: Sarwar
authors.forename: Yasir J
authors.initials: YJ
authors.lastname: Sepah
authors.forename: Quan D
authors.initials: QD
authors.lastname: Nguyen
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A