Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.ajo.2013.11.012
Title: Management paradigms for diabetic macular edema
Authors: Mitchell, P.
Wong, T.Y. 
Issue Date: Mar-2014
Source: Mitchell, P., Wong, T.Y. (2014-03). Management paradigms for diabetic macular edema. American Journal of Ophthalmology 157 (3) : 505-513.e8. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ajo.2013.11.012
Abstract: Purpose To provide evidence-based recommendations for diabetic macular edema (DME) management based on updated information from publications on DME treatment modalities. Design Perspective. Methods A literature search for "diabetic macular edema" or "diabetic maculopathy" was performed using the PubMed, Cochrane Library, and ClinicalTrials.gov databases to identify studies from January 1, 1985 to July 31, 2013. Meta-analyses, systematic reviews, and randomized controlled trials with at least 1 year of follow-up published in the past 5 years were preferred sources. Results Although laser photocoagulation has been the standard treatment for DME for nearly 3 decades, there is increasing evidence that superior outcomes can be achieved with anti-vascular endothelial growth factor (anti-VEGF) therapy. Data providing the most robust evidence from large phase II and phase III clinical trials for ranibizumab demonstrated visual improvement and favorable safety profile for up to 3 years. Average best-corrected visual acuity change from baseline ranged from 6.1-10.6 Early Treatment Diabetic Retinopathy Study (ETDRS) letters for ranibizumab, compared to 1.4-5.9 ETDRS letters with laser. The proportion of patients gaining ≥10 or ≥15 letters with ranibizumab was at least 2 times higher than that of patients treated with laser. Patients were also more likely to experience visual loss with laser than with ranibizumab treatment. Ranibizumab was generally well tolerated in all studies. Studies for bevacizumab, aflibercept, and pegaptanib in DME were limited but also in favor of anti-VEGF therapy over laser. Conclusions Anti-VEGF therapy is superior to laser photocoagulation for treatment of moderate to severe visual impairment caused by DME.
Source Title: American Journal of Ophthalmology
URI: http://scholarbank.nus.edu.sg/handle/10635/108668
ISSN: 00029394
DOI: 10.1016/j.ajo.2013.11.012
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

40
checked on Apr 24, 2018

WEB OF SCIENCETM
Citations

29
checked on Apr 24, 2018

Page view(s)

46
checked on Mar 12, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.