Therapeutic Approaches for Treatment of Diabetic Macular Edema.

Wydanie 3/2022
str. 26 – 31

Autorzy: Michał Post^1,2, Dorota Polakowska¹, Dominika Wróbel-Dudzińska^2,3, Jacek P. Szaflik^1,4,5

1. Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie.
2. Klub 40, Polskie Towarzystwo Okulistyczne.
3. Klinika Diagnostyki i Mikrochirurgii Jaskry Uniwersytetu Medycznego w Lublinie.
   Kierownik: prof. dr hab. n. med. Tomasz Żarnowski.
4. Katedra i Klinika Okulistyki Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego.
   Kierownik: prof. dr hab. n. med. Jacek P. Szaflik.
5. Centrum Mikrochirurgii Oka „Laser” w Warszawie.

Summary: 

Diabetic macular edema is an ocular complication of diabetes mellitus, leading to significant visual impairment. The pathogenesis of diabetic macular edema occurs through the interaction of multiple molecular mediators, including the overexpression of several growth factors, including vascular endothelial growth factor, angiopoietin-1, and -2, insulin-like growth factor-1, etc. These growth factors mediate endothelial cell proliferation, angiogenesis, protease production. Treatment for diabetic macular edema involves primary management of diabetes mellitus, laser photocoagulation, and pharmacotherapeutics targeting mediators, namely, the anti-vascular endothelial growth factor pathway. The introduction of anti-vascular endothelial growth factor therapies has resulted in significant clinical improvements compared to laser photocoagulation alone. However, the presence of anti-vascular endothelial growth factor non-responders and multiple factors influencing the visual outcome after anti-vascular endothelial growth factor treatment have necessitated the development of new therapeutic aproaches. In this review, we provide an analysis of current management strategies to the treatment of diabetic macular edema.