Management of diabetic macular edema: experts’ consensus in Taiwan

Jiann Torng Chen, Lee Jen Chen, San Ni Chen, Wen Lu Chen, Cheng Kuo Cheng, Sheng Min Hsu, Shwu Jiuan Sheu, Wen Chuan Wu, Chang Hao Yang, Chung May Yang, Ling Yeung, De Kuang Hwang, Shih Jen Chen

Research output: Contribution to journalReview article

Abstract

Diabetic macular edema (DME) is the most common cause of vision loss among patients with diabetes mellitus (DM), rendering it an important growing challenge in ophthalmology. In the past decades, the management strategies for DME had a few paradigm shifts, and the advent of an expanding number of anti-vascular endothelial growth factor (VEGF) agents also calls for an in-depth examination of the currently available evidence. This article was composed with the intention to provide recommendations for practicing clinicians to improve the management and, through it the outcomes of DME. Drawing from current guideline recommendations, clinical trial findings and local clinical experiences, these consensus recommendations for the management of DME were formed by an expert panel through iterations of discussion and voting. First, the treatment goal of DME is to achieve best visual outcome with edema improvement while minimizing treatment burden. Second, anti-VEGF therapy should be considered as the first-line treatment for patients with center-involving DME causing vision loss. Baseline visual acuity (VA) and central subfield thickness (CST) should be taken into consideration when choosing anti-VEGF agents. Third, early intensive anti-VEGF therapy (at least 3 monthly doses) is important for better patients’ VA and anatomical improvement. In non-responders who have already been treated with 3-5 injections of anti-VEGF agents, it is reasonable to switch to other modalities, such as steroids. Finally, for the follow-up phase, fixed or individualized dosing should be considered based on VA and OCT.

Original languageEnglish
Pages (from-to)235-242
Number of pages8
JournalJapanese Journal of Ophthalmology
Volume64
Issue number3
DOIs
Publication statusPublished - 2020 May 1

All Science Journal Classification (ASJC) codes

  • Ophthalmology

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  • Cite this

    Chen, J. T., Chen, L. J., Chen, S. N., Chen, W. L., Cheng, C. K., Hsu, S. M., Sheu, S. J., Wu, W. C., Yang, C. H., Yang, C. M., Yeung, L., Hwang, D. K., & Chen, S. J. (2020). Management of diabetic macular edema: experts’ consensus in Taiwan. Japanese Journal of Ophthalmology, 64(3), 235-242. https://doi.org/10.1007/s10384-020-00741-4