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Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies

Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing... Downloaded from http://journals.lww.com/apjoo by BhDMf5ePHKbH4TTImqenVA+lpWIIBvonhQl60EtgtdlLYrLzSPu+hQedJnbNaXBf on 03/22/2021 REVIEW ARTICLE Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies Kevin Miller, MD, and Jorge A. Fortun, MD in industrialized nations. The pathogenesis of diabetic macular Abstract: Diabetic retinopathy and diabetic macular edema comprise a edema is multifactorial and complex, with the hyperglycemic state major source of visual disability throughout the developed world. The eti- caused by diabetes inducing multiple pathologic abnormalities, ology and pathogenesis of macular edema is intricate and multifactorial, ultimately producing the sight-threatening conditions of macular in which the hyperglycemic state in diabetes induces a microangiopathy. edema and proliferative, neovascular retinopathy. Through several inflammatory and vasogenic mediators, including vas- Although historically diabetic macular edema has been treat- cular endothelial growth factor (VEGF) upregulation and inflammatory ed with laser photocoagulation and pars plana vitrectomy, recent cytokines and chemokines, pathologic changes are induced in the vascu- advances in pharmacological therapies demonstrated remarkable lar endothelium triggering breakdown of the blood retinal barrier, causing effectiveness in the treatment of macular edema. Specifically, extravasation of fluid into the extracellular space and manifesting clini- anti‒vascular endothelial growth factor (VEGF) therapy has cally as macular edema, resulting in visual loss. The advent of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Asia-Pacific Journal of Ophthalmology Wolters Kluwer Health

Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies

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Publisher
Wolters Kluwer Health
Copyright
© 2018 by Asia Pacific Academy of Ophthalmology
ISSN
2162-0989
eISSN
2475-5028
DOI
10.22608/APO.2017529
Publisher site
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Abstract

Downloaded from http://journals.lww.com/apjoo by BhDMf5ePHKbH4TTImqenVA+lpWIIBvonhQl60EtgtdlLYrLzSPu+hQedJnbNaXBf on 03/22/2021 REVIEW ARTICLE Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies Kevin Miller, MD, and Jorge A. Fortun, MD in industrialized nations. The pathogenesis of diabetic macular Abstract: Diabetic retinopathy and diabetic macular edema comprise a edema is multifactorial and complex, with the hyperglycemic state major source of visual disability throughout the developed world. The eti- caused by diabetes inducing multiple pathologic abnormalities, ology and pathogenesis of macular edema is intricate and multifactorial, ultimately producing the sight-threatening conditions of macular in which the hyperglycemic state in diabetes induces a microangiopathy. edema and proliferative, neovascular retinopathy. Through several inflammatory and vasogenic mediators, including vas- Although historically diabetic macular edema has been treat- cular endothelial growth factor (VEGF) upregulation and inflammatory ed with laser photocoagulation and pars plana vitrectomy, recent cytokines and chemokines, pathologic changes are induced in the vascu- advances in pharmacological therapies demonstrated remarkable lar endothelium triggering breakdown of the blood retinal barrier, causing effectiveness in the treatment of macular edema. Specifically, extravasation of fluid into the extracellular space and manifesting clini- anti‒vascular endothelial growth factor (VEGF) therapy has cally as macular edema, resulting in visual loss. The advent of

Journal

The Asia-Pacific Journal of Ophthalmology – Wolters Kluwer Health

Published: Jan 1, 2018

Keywords: diabetes mellitus

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