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diabetic macular edema (DME)
See macular edema, diabetic retinopathy
Management:
- intravitreal VEGF inhibitor improves vision in patients with diabetic macular edema [1]
- intravitreal ranibizumab only if:
- the eye has a central retinal thickness of >= 400 uM at the start of treatment [1] (NICE)
Notes:
- fluocinolone acetonide intravitreal implant is not recommended [1] (NICE)
- cost to patients per intravitreal dose (2015) [1]
- bevacizumab: $50
- ranibizumab: $1,200
- aflibercept: $1,950
- brolucizumab: ?
General
macular edema; retinal edema
diabetic retinopathy (DR, proliferative {PDR} & non-proliferative)
References
- Young K, Sadough S
Anti-VEGF Agents Tied to Improved Visual Acuity in Diabetic
Macular Edema
Physician's First Watch, Feb 19, 2015
David G. Fairchild, MD, MPH, Editor-in-Chief
Massachusetts Medical Society
http://www.jwatch.org
- The Diabetic Retinopathy Clinical Research Network.
Aflibercept, Bevacizumab, or Ranibizumab for Diabetic Macular Edema.
N Engl J Med. 2015 Feb 18.
PMID: 25692915
http://www.nejm.org/doi/full/10.1056/NEJMoa1414264
- Martin DF, Maguire MG.
Treatment Choice for Diabetic Macular Edema.
N Engl J Med. 2015 Feb 18. [Epub ahead of print]
PMID: 25692914
http://www.nejm.org/doi/full/10.1056/NEJMe1500351