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Intravitreal steroid versus macular laser for treatment of diabetic macular edema

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Abstract

Diabetic macular edema is a leading cause of vision loss in the United States. Focal/grid laser photocoagulation has been the gold standard for treatment over the past two decades. Intravitreal pharmacologic treatments increasingly have been used over the past 5 years. Various studies have shown the possible benefits of intravitreal corticosteroids and anti-vascular endothelial growth factors in the treatment of diabetic macular edema. However, focal/grid laser photocoagulation continues to be the only proven safe and effective treatment for diabetic macular edema.

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References and Recommended Reading

  1. American Diabetes Association: Diabetes statistics. Available at: http://www.diabetes.org/diabetes-statistics.jsp. Accessed June 13, 2008.

  2. Centers for Disease Control and Prevention: Blindness caused by diabetes: Massachusetts, 1987–1994. MMWR Morb Mortal Wkly Rep 1996, 45:937–941.

    Google Scholar 

  3. Klein R, Klein B, Moss S, et al.: The Wisconsin Epidemiologic Study of Diabetic Retinopathy, IV: diabetic macular edema. Ophthalmology 1984, 91:1464–1474

    PubMed  CAS  Google Scholar 

  4. Early Treatment Diabetic Retinopathy Study Research Group: Photocoagulation for diabetic macular edema: ETDRS report number 4. Int Ophthalmol Clin 1987, 27:265–272.

    Article  Google Scholar 

  5. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med 1993, 329:977–986.

  6. UK Prospective Diabetes Study Group: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998, 352:837–853.

    Article  Google Scholar 

  7. Stratton IM, Cull CA, Adler AI, et al.: Additive effects of glycaemia and blood pressure exposure on risk of complications in type 2 diabetes: a prospective observational study (UKPDS 75). Diabetologia 2006, 49:1761–1769.

    Article  PubMed  CAS  Google Scholar 

  8. Hsu J: Drug delivery methods for posterior segment disease. Curr Opin Ophthalmol 2007, 18:235–239.

    Article  PubMed  Google Scholar 

  9. Martidis A, Duker JS, Greenberg PB, et al.: Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 2002, 109:920–927.

    Article  PubMed  Google Scholar 

  10. Lewis H, Abrams GW, Blumenkranz MS, Campo RV: Vitrectomy for diabetic macular traction and edema associated with posterior hyaloidal traction. Ophthalmology 1992, 99:753–759.

    PubMed  CAS  Google Scholar 

  11. Cunningham ET Jr, Adamis AP, Altaweel M, et al.: Macugen Diabetic Retinopathy Study Group: A phase II randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology 2005, 112:1747–1757.

    Article  PubMed  Google Scholar 

  12. Diabetic Retinopathy Clinical Research Network: A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology 2007, 114:1860–1867.

    Article  Google Scholar 

  13. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study Research Group. Arch Ophthalmol 1985, 103:1796–1806.

  14. Antcliff RJ, Marshall J: The pathogenesis of edema in diabetic maculopathy. Semin Ophthalmol 1999, 14:223–232.

    Article  PubMed  CAS  Google Scholar 

  15. Qaum T, Xu Q, Joussen AM, et al.: VEGF-initiated blood-retinal barrier breakdown in early diabetes. Invest Ophthalmol Visual Sci 2001, 42:2408–2413.

    CAS  Google Scholar 

  16. Graham RO, Peyman GA: Intravitreal injection of dexamethasone. Treatment of experimentally induced endophthalmitis. Arch Ophthalmol 1974, 92:149–154.

    PubMed  CAS  Google Scholar 

  17. Beer PM, Bakri SJ, Singh RJ, et al.: Intraocular concentration and pharmacokinetics of triamcinolone acetonide after a single intravitreal injection. Ophthalmology 2003, 110:681–686.

    Article  PubMed  Google Scholar 

  18. Ciulla TA, Walker JD, Fong DS, Criswell MH: Corticosteroids in posterior segment disease: an update on new delivery systems and new indications. Curr Opin Ophthalmol 2004, 15:211–220.

    Article  PubMed  Google Scholar 

  19. Grover D, Li TJ, Chong CC: Intravitreal steroids for macular edema in diabetes. Cochrane Database Syst Rev 2008, 23:CD005656.

    Google Scholar 

  20. Diabetic Retinopathy Clinical Research Network: A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology 2008, 115:1447–1449.

    Article  Google Scholar 

  21. Cheng CK, Berger AS, Pearson PA, et al.: Intravitreal sustained-release dexamethasone device in the treatment of experimental uveitis. Invest Ophthalmol Vis Sci 1995, 36:44–53.

    Google Scholar 

  22. Pearson PA, Bevy B; Fluconolone Acetonide Implant Study Group: Fluocinolone acetonide intravitreal implant to treat diabetic macular edema: 2-year results of a multi-center clinical trial. Presented at Association for Research in Vision and Ophthalmology Annual Meeting. Fort Lauderdale, FL; May 1–5, 2005.

  23. Berger AS, Cheng CK, Pearson PA, et al.: Intravitreal sustained release corticosteroid-5-fluoruracil conjugate in the treatment of experimental proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci 1996, 37:2318–2325.

    PubMed  CAS  Google Scholar 

  24. McMahon G: VEGF receptor signaling in tumor angiogenesis. Oncologist 2000, 5(Suppl 1):3–10.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. University of Wisconsin Hospital and Clinics, Room 400, 406 Science Drive, Madison, WI, 53711, USA

    Michael Ip

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  1. Jonathan Gunther
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  2. Michael Ip
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Correspondence to Michael Ip.

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Gunther, J., Ip, M. Intravitreal steroid versus macular laser for treatment of diabetic macular edema. Curr Diab Rep 9, 272–276 (2009). https://doi.org/10.1007/s11892-009-0042-5

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  • DOI: https://doi.org/10.1007/s11892-009-0042-5

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