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Expert Opinion on Biological Therapy Volume 16, 2016 - Issue 3

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Treatment strategies for refractory diabetic macular edema: switching anti-VEGF treatments, adopting corticosteroid-based treatments, and combination therapy

Rehan M. HussainDepartment of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA

Thomas A. CiullaRetina Service, Midwest Eye Institute, Indianapolis, IN, USACorrespondence[email protected]

Pages 365-374 | Received 14 Oct 2015, Accepted 09 Dec 2015, Published online: 12 Jan 2016

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https://doi.org/10.1517/14712598.2016.1131265
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Papers of note have been highlighted as either of interest (*) or of considerable interest (**) to readers
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Landmark study that resulted in FDA approval of ranibizumab to treat DME.

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Prospective study that reports efficacy of ranibizumab in treating DME refractory to bevacizumab treatment.

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Comparison of continued bevacizumab monotherapy vs. combination treatment with dexamethasone intravitreal implant and bevacizumab in cases of DME that did not show complete response to bevacizumab monotherapy.

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Treatment strategies for refractory diabetic macular edema: switching anti-VEGF treatments, adopting corticosteroid-based treatments, and combination therapy

References

Excellent overview of the pathophysiology of DME.

Landmark study that resulted in FDA approval of ranibizumab to treat DME.

Landmark study that resulted in FDA approval of aflibercept to treat DME.

The only large randomized clinical trial to directly compare bevacizumab, ranibizumab, and aflibercept in treating DME, which showed superiority of aflibercept in patients with BCVA worse than 20/40.

Prospective study that reports efficacy of ranibizumab in treating DME refractory to bevacizumab treatment.

Retrospective review that reports improved BCVA and macular thickness for patients who switch to aflibercept after incomplete response with bevacizumab and ranibizumab.

Comparison of continued bevacizumab monotherapy vs. combination treatment with dexamethasone intravitreal implant and bevacizumab in cases of DME that did not show complete response to bevacizumab monotherapy.

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Treatment strategies for refractory diabetic macular edema: switching anti-VEGF treatments, adopting corticosteroid-based treatments, and combination therapy

References

Excellent overview of the pathophysiology of DME.

Landmark study that resulted in FDA approval of ranibizumab to treat DME.

Landmark study that resulted in FDA approval of aflibercept to treat DME.

The only large randomized clinical trial to directly compare bevacizumab, ranibizumab, and aflibercept in treating DME, which showed superiority of aflibercept in patients with BCVA worse than 20/40.

Prospective study that reports efficacy of ranibizumab in treating DME refractory to bevacizumab treatment.

Retrospective review that reports improved BCVA and macular thickness for patients who switch to aflibercept after incomplete response with bevacizumab and ranibizumab.

Comparison of continued bevacizumab monotherapy vs. combination treatment with dexamethasone intravitreal implant and bevacizumab in cases of DME that did not show complete response to bevacizumab monotherapy.

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