title: Sustained-release steroids for the treatment of diabetic macular edema.
abstract: Glucocorticoids have been used for decades in the treatment of ocular disorders via topical, periocular, and more recently intravitreal routes. However, their exact mechanisms of action on ocular tissues remain imperfectly understood. Fortunately, two recently approved intravitreal sustained-release drug delivery systems have opened new perspectives for these very potent drugs. To date, among other retinal conditions, their label includes diabetic macular edema, for which a long-lasting therapeutic effect has been demonstrated both morphologically and functionally in several randomized clinical trials. The rate of ocular complications of intravitreal sustained-release steroids, mainly cataract formation and intraocular pressure elevation, is higher than with anti-vascular endothelial growth factor agents. Yet, a better understanding of the mechanisms underlying these adverse effects and the search for the minimal efficient dose should help optimize their therapeutic window.
authors.affiliation: Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Avenue de France 15, 1004, Lausanne, Switzerland. adaruich.matet@gmail.com.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Daruich
authors.affiliation: Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Avenue de France 15, 1004, Lausanne, Switzerland. alexmatet@gmail.com.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Matet
authors.affiliation: Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Avenue de France 15, 1004, Lausanne, Switzerland. francine.beharcohen@fa2.ch.|Sorbonne Universités, UPMC Université Paris 06, UMR 1138, Centre de Recherche des Cordeliers, 3 rue de l'Ecole de Médecine, 75006, Paris, France. francine.beharcohen@fa2.ch.|INSERM, UMR 1138, Centre de Recherche des Cordeliers, 3 rue de l'Ecole de Médecine, 75006, Paris, France. francine.beharcohen@fa2.ch.|Université Paris Descartes, Sorbonne Paris Cité, UMR 1138, Centre de Recherche des Cordeliers, 3 rue de l'Ecole de Médecine, 75006, Paris, France. francine.beharcohen@fa2.ch.
authors.forename: Francine
authors.initials: F
authors.lastname: Behar-Cohen
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D048909:Diabetes Complications / Q000188:drug therapy / Q000378:metabolism*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D013256:Steroids / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D003692:Delayed-Action Preparations; D005938:Glucocorticoids; D013256:Steroids
keywords: Delayed-action preparations; Dexamethasone; Diabetes mellitus; Fluocinolone acetonide; Glucocorticoids; Macular edema; Therapy