Update on corticosteroids for diabetic macular edema

Stephen G. Schwartz, Ingrid U. Scott, Michael W. Stewart, Harry W. Flynn

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Diabetic macular edema (DME) remains an important cause of visual loss. Although anti-vascular endothelial growth factor (VEGF) agents are generally used as first-line treatments for patients with center-involving DME, there is an important role for corticosteroids as well. Corticosteroids may be especially useful in pseudophakic patients poorly responsive to anti-VEGF therapies, in patients wishing to reduce the number of required injections, and in pregnant patients. Intravitreal triamcinolone acetonide has been used for many years but is not approved for this indication. An extended-release bioerodable dexamethasone delivery system and an extended-release nonbioerodable fluocinolone acetonide insert have both achieved regulatory approval for the treatment of DME. All intravitreal corticosteroids are associated with risks of cataract progression, elevation of intraocular pressure, and endophthalmitis. There is no current consensus regarding the use of corticosteroids, but they are valuable for selected patients with center-involving DME.

Original languageEnglish (US)
Pages (from-to)1723-1730
Number of pages8
JournalClinical Ophthalmology
Volume10
DOIs
StatePublished - Sep 8 2016

Keywords

  • Dexamethasone
  • Diabetic macular edema
  • Fluocinolone acetonide
  • Randomized clinical trial
  • Triamcinolone acetonide
  • Vascular endothelial growth factor

ASJC Scopus subject areas

  • Ophthalmology

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