Present Situation And Prospect Of Treatment Of Diabetic Macular Edema

Diabetic macular edema is one of the factors that seriously affect visual acuity in DR.At present,with the improvement of surgical level,vitreous hemorrhage,retinal detachment,cataract or neovascular glaucoma have all improved visual acuity through surgery to varying degrees.Macular disease is the main cause of visual impairment and blindness in DR^[1].DME,T1 DM may occur in all stages of DR 5 years before the course of disease may produce macular edema^[2],5%T2 DM patients may find macular edema at the time of diagnosis^[3].The pathogenesis of diabetic macular edema is complex and not fully clear.it mainly includes the destruction of blood-retinal barrier function,VEGF,inflammatory factors,hemodynamic effects and so on.At present,the main treatment methods of DME include:medical treatment,laser treatment,anti-VEGF drugs,steroids,surgery and combined treatment.In the past,laser therapy is the standard treatment of DME,especially for CSDME,laser therapy is its classical treatment.Now anti-VEGF has attracted more attention and replaced it as a first-line treatment,but because of its high price and frequent injection,it is difficult for patients to continue treatment,combined therapy has become the main trend.With the in-depth study of the mechanism of DME,are there new therapeutic drugs and better treatment methods?In recent years,the application of NAVILAS photocoagulation system,dexamethasone intravitreous implants and immunosuppressive drug sirolimus has opened up new ideas for the treatment of diffuse,refractory and recurrent DME.Whether it is suitable for Chinese people remains to be confirmed by clinical studies.Therefore,the clinical characteristics,pathogenesis,treatment status and prospect of DME are reviewed in this paper.