title: Updates in the management of diabetic macular edema.
abstract: Diabetes mellitus is a chronic disease which has multiple effects on different end-organs, including the retina. In this paper, we discuss updates on diabetic macular edema (DME) and the management options. The underlying pathology of DME is the leakage of exudates from retinal microaneurysms, which trigger subsequent inflammatory reactions. Both clinical and imaging techniques are useful in diagnosing, classifying, and gauging the severity of DME. We performed a comprehensive literature search using the keywords "diabetes," "macula edema," "epidemiology," "pathogenesis," "optical coherence tomography," "intravitreal injections," "systemic treatment," "hypertension," "hyperlipidemia," "anemia," and "renal disease" and collated a total of 47 relevant articles published in English language. The main modalities of treatment currently in use comprise laser photocoagulation, intravitreal pharmacological and selected systemic pharmacological options. In addition, we mention some novel therapies that show promise in treating DME. We also review systemic factors associated with exacerbation or improvement in DME.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mathew
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Yunirakasiwi
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597 ; Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828.
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Sanjay
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008028:Light Coagulation / Q000379:methods*; D008269:Macular Edema / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000069579:Ranibizumab / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab; D000069579:Ranibizumab