review · International Journal of Retina and Vitreous
Diabetes mellitus causes vascular damage that frequently manifests as diabetic macular edema, a principal cause of substantial visual impairment globally among working-age individuals. While long-term visual deterioration can be mitigated through early intervention, current first-line therapies relying on anti-VEGF drugs face critical drawbacks. Many patients suffer disease recurrence, limited therapeutic response, or drug resistance due to the complex underlying mechanisms of the disease. This situation creates a pressing demand for innovative treatment strategies that achieve superior disease control while minimising treatment frequency. An evaluation of current therapeutic agents alongside emerging interventions highlights an evolving management landscape for diabetic macular edema. However, large clinical trials remain necessary to establish robust evidence in support of these innovative therapeutic options.
Diabetic macular edema is a leading cause of vision loss among working-age populations worldwide. Although standard therapies exist, treatment resistance and disease relapses often compromise patient outcomes. Identifying emerging therapies helps clinicians and healthcare planners recognise where current treatments fall short, highlighting the ongoing clinical transition towards interventions that offer better disease control and demand fewer clinical visits.
Targeted at ophthalmic drug developers and clinical researchers, this work outlines the need for next-generation retinal therapies that overcome the shortcomings of anti-VEGF agents. Commercial interest lies in therapies that reduce treatment frequency and overcome biological resistance. The emerging treatments discussed remain at an investigational stage and require validation through large-scale clinical trials before clinical and market deployment can occur.
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One of the most common health concerns disturbing people within working years globally is diabetes mellitus (DM). One well-known consequence of DM is vascular damage, which can manifest as macro- and microangiopathy affecting the ocular retina. Therefore, Diabetic macular edema (DME) is a major sight-threatening complication of diabetic retinopathy (DR) worldwide. It is the most prevalent cause of significant vision impairment in diabetic patients. Long-term vision loss can be avoided by following early DME treatment guidelines in everyday life. Hence, there are various therapeutic approaches for DME management. Currently, the first-line treatment for DME is anti-VEGF family drugs, such as ranibizumab, brolucizumab, bevacizumab, and aflibercept. Nevertheless, relapses of the disease, inadequate response, and resistance during anti-VEGF therapy are still seen because of the intricate pathophysiological foundation of the disease. Consequently, there is an excellent requirement for therapeutic approaches to advance and become better at controlling diseases more satisfactorily and require fewer treatments overall. We conducted a thorough literature search in the current review to present a comprehensive overview of the primary data about the current DME therapeutic agents. We also covered the novel advances in DME management and probable future treatments being investigated and developed. This review recommended that Large clinical trials should afford sufficient evidence to support these innovative treatment modalities.
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DOI: 10.1186/s40942-024-00603-y
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