Unmet Needs in Diabetic Macular Edema

Abstract

Purpose: The purpose of this article was to review current therapies for diabetic macular edema (DME) and to discuss current unmet needs in the treatment of DME. Methods: The peer-reviewed literature was searched for information about the results of clinical trials on the treatment of DME. The Internet, Retina Society meeting abstracts, and publications (both peer-reviewed and non-peer-reviewed) were searched for information about ongoing clinical trials on the treatment of DME. Results: Laser photocoagulation until recently was the only treatment with proven efficacy in phase III randomized clinical trials for DME. Although visual acuity can be stabilized with laser treatment, visual improvement is uncommon. Recently, a phase III clinical trial showed that intravitreal ranibizumab with or without prompt laser resulted in superior visual acuity results at one year compared with eyes treated with triamcinolone or laser alone. Sustained drug delivery systems, preventive therapies, and novel drugs that prevent foveal lipid, reverse ischemia, and increase blood flow to the ischemic retina are needed. Conclusions: Current drug development is addressing the unmet needs of improving visual acuity in eyes with DME. Research is needed to develop novel therapies for sustained drug delivery, prevention of macular edema, and prevention of complications related to chronic macular edema.