Update on corticosteroids for diabetic macular edema.

Area of Science:

• Ophthalmology
• Endocrinology
• Pharmacology

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss.
• Anti-vascular endothelial growth factor (VEGF) agents are standard first-line treatments for center-involving DME.
• Corticosteroids present a valuable therapeutic option for specific patient populations.

Purpose of the Study:

• To review the role and efficacy of corticosteroids in managing diabetic macular edema (DME).
• To highlight specific patient groups who may benefit from corticosteroid therapy.
• To discuss the risks and approved formulations of intravitreal corticosteroids for DME.

Main Methods:

• Review of current literature on corticosteroid use in diabetic macular edema.
• Analysis of approved corticosteroid formulations and their delivery systems.
• Discussion of clinical considerations, including patient selection and potential adverse effects.

Main Results:

• Corticosteroids are effective for DME, especially in pseudophakic patients resistant to anti-VEGF treatments.
• Approved extended-release corticosteroid formulations (dexamethasone, fluocinolone acetonide) are available for DME treatment.
• Intravitreal corticosteroids are associated with risks including cataract progression, elevated intraocular pressure, and endophthalmitis.

Conclusions:

• Corticosteroids are a valuable treatment option for selected patients with center-involving DME.
• While not universally recommended, they offer benefits for specific patient profiles and may reduce injection frequency.
• Careful patient selection and monitoring are essential due to associated risks.