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Specialist evaluates current treatments for DME
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PARIS — Laser photocoagulation is still the gold standard in the treatment of diabetic macular edema and should be used as the benchmark in evaluation of other treatments, according to Pascale Massin, MD, speaking at the meeting of the French Society of Ophthalmology.
"Studies have shown an average gain of two to three lines following laser treatment. An additional effect on vision is obtained over time because laser photocoagulation has a delayed, progressive effect," she said.
Corticosteroids have drawbacks, such as a high incidence of cataract, and should only be used in case of DME refractory to laser treatment in pseudophakic patients.
Anti-VEGF therapy with Lucentis (ranibizumab, Genentech) has shown efficacy.
"A fixed schedule of 10 monthly injections was proved to effectively improve vision. However, the high frequency of injections is traumatic, costly and may not be realistic outside clinical studies," Dr. Massin said.
Association with laser might be effective in reducing the frequency of injections and could be more cost-effective.
"A more precise phenotyping of DME is necessary to better assess indications," Dr. Massin said.
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