title: Considerations for management of patients with diabetic macular edema: Optimizing treatment outcomes and minimizing safety concerns through interdisciplinary collaboration.
abstract: Diabetes is a growing worldwide epidemic and a leading cause of blindness in working-age people around the world. Diabetic retinopathy (DR) and diabetic macular edema (DME) are common causes of visual impairment in people with diabetes and often indicate the presence of diabetes-associated preclinical micro- and macrovascular complications. As such, patients with DR and DME often display complex, highly comorbid profiles. Several treatments are currently available for the treatment of DME, including anti-vascular endothelial growth factor (VEGF) agents, which are administered via intravitreal injection. While the safety profiles of approved ocular anti-VEGF therapies have been reassuring, the high-risk nature of the DME patient population means that treatment must be carefully considered and a holistic approach to disease management should be taken. This requires multidisciplinary, collaborative care involving all relevant specialties to ensure that patients not only receive prompt treatment for DME but also appropriate consideration is taken of any systemic comorbidities to evaluate and minimize potentially serious safety issues.
authors.affiliation: Diabetes and Vascular Research Centre, University of Exeter Medical School, Exeter, UK. Electronic address: d.strain@exeter.ac.uk.
authors.forename: W David
authors.initials: WD
authors.lastname: Strain
authors.affiliation: Sant Marti de Provençals Primary Care Centres, Institut Català de la Salut, Barcelona, Spain; University Research Institute in Primary Care (IDIAP Jordi Gol), Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cos
authors.affiliation: Kantonsspital Baselland, Eye Clinic, Liestal, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Prünte
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D001766:Blindness / Q000517:prevention & control; D003299:Cooperative Behavior; D003930:Diabetic Retinopathy / Q000150:complications / Q000628:therapy*; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects*; D008269:Macular Edema / Q000209:etiology / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A
keywords: Anti-VEGF; Diabetes; Diabetic macular edema; Multidisciplinary teams; Safety