Forming a Consensus: Data and Guidance for Physicians Treating Diabetic Macular Edema

Carmen A. Puliafito, Scott W. Cousins, Jason Bacharach, Victor H. Gonzalez, Nancy M. Holekamp, Pauline T. Merrill, Matthew P. Ohr, Richard K. Parrish, Christopher D. Riemann

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


The diabetic macular edema (DME) treatment paradigm has evolved as the understanding of the disease pathology has grown. Since 2012, four pharmacotherapies have been approved by the U.S. Food and Drug Administration for the treatment of DME. First-line treatment of DME with anti-vascular endothelial growth factor [VEGF] agents has become the gold standard; however, an appreciable percentage of patients do not respond to anti-VEGF therapies. In patients who inadequately respond to anti-VEGF therapies, the underlying disease pathology may be mediated by a multitude of growth factors and inflammatory cytokines. For these patients, corticosteroids are an attractive treatment option because they not only downregulate VEGF, but also an array of cytokines. The phase 3 MEAD and FAME trials demonstrated significant visual acuity improvements associated with dexamethasone and fluocinolone acetonide, respectively, in patients with DME; however, class-specific adverse events, including increased intraocular pressure and cataract development, must be considered before use. A panel of experts gathered during the 2015 annual meeting of the American Academy of Ophthalmology for a roundtable discussion focused on patient selection and adverse event management associated with the use of the 0.19 mg fluocinolone acetonide intravitreal implant.

Original languageEnglish (US)
Pages (from-to)S4-S15
JournalOphthalmic surgery, lasers & imaging retina
Issue number4
StatePublished - Apr 1 2016

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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