Diabetic macular edema: Classification, medical and laser therapy

F. Bandello, Roman Pognuz, A. Polito, A. Pirracchio, F. Menchini, M. Ambesi

Research output: Contribution to journalArticle

Abstract

Purpose. to propose and describe a new classification of diabetic macular edema (DME) based on its etiopathogenetic features and to present efficacy and safety data on medical and laser treatments currently used and under investigation. Methods. available literature on DME has been reviewed and information provided by contact lens biomicroscopy, fluorescein angiography and optical coherence tomomography has been combined; published data from trials and reports investigating effectiveness of medical and laser treatments were also analyzed. Results. DME was classified according to its main etiopathogenetic components: prevalently retinovascular, tractional and with taut attached posterior hyaloid, each of them having peculiar aspects on fundus, angiographic and tomographic examination. Focal laser treatment remains the only effective intervention, as shown by a large randomized controlled trial, but new less-invasive photocoagulation strategies (i.e., light laser photocoagulation and subthreshold micropulse diode laser) as well as pharmacological approaches (i.e., antioxidants, PKC inhibitors, aldose-reductase and AGE inhibitors, VEGF inhibitors, intravitreal triamcinolone) are emerging. Conclusions. based on our review a classification of DME was developed that may prove useful in making the appropriate treatment decision; the new laser and pharmacological treatments currently investigated are promising and need to be confirmed by large, controlled clinical trials.

Original languageEnglish
Pages (from-to)251-258
Number of pages8
JournalSeminars in Ophthalmology
Volume18
Issue number4
DOIs
Publication statusPublished - Dec 2003

Fingerprint

Macular Edema
Laser Therapy
Lasers
Light Coagulation
Pharmacology
Therapeutics
Triamcinolone
Aldehyde Reductase
Semiconductor Lasers
Fluorescein Angiography
Contact Lenses
Controlled Clinical Trials
Vascular Endothelial Growth Factor A
Randomized Controlled Trials
Antioxidants
Safety
Light

Keywords

  • Diabetic macular edema
  • Laser therapy
  • PCK inhibitors
  • Posterior hyaloid traction
  • VEGF inhibitors

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Bandello, F., Pognuz, R., Polito, A., Pirracchio, A., Menchini, F., & Ambesi, M. (2003). Diabetic macular edema: Classification, medical and laser therapy. Seminars in Ophthalmology, 18(4), 251-258. https://doi.org/10.1080/08820530390895262

Diabetic macular edema : Classification, medical and laser therapy. / Bandello, F.; Pognuz, Roman; Polito, A.; Pirracchio, A.; Menchini, F.; Ambesi, M.

In: Seminars in Ophthalmology, Vol. 18, No. 4, 12.2003, p. 251-258.

Research output: Contribution to journalArticle

Bandello, F, Pognuz, R, Polito, A, Pirracchio, A, Menchini, F & Ambesi, M 2003, 'Diabetic macular edema: Classification, medical and laser therapy', Seminars in Ophthalmology, vol. 18, no. 4, pp. 251-258. https://doi.org/10.1080/08820530390895262
Bandello, F. ; Pognuz, Roman ; Polito, A. ; Pirracchio, A. ; Menchini, F. ; Ambesi, M. / Diabetic macular edema : Classification, medical and laser therapy. In: Seminars in Ophthalmology. 2003 ; Vol. 18, No. 4. pp. 251-258.
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