Anti‐VEGF for the treatment of diabetic macular edema

Purpose To assess efficacy and safety of intraocular injections of anti‐VEGF in patients with diabetic macular edema Methods The gold standard for treatment has been laser coagulation. Limitations of this therapy are refractive DME, ischemic diabetic maculopathy and complications after laser application. The need for a non‐destructive and effective strategy has led to investigations regarding VEGF inhibitors for reduction of vessel leakage and oedema formation. Trials for different anti‐VEGF compounds are nearing completion or are completed. Data regarding dose, injection scheme and practicable application form are reviewed. Combination of laser therapy and anti‐VEGF will be reported. Results For diabetic macular edema, trials of intravitreal pegaptanib and intravitreal ranibizumab have shown short‐term benefit in visual acuity. Intravitreal bevacizumab also has been shown to have beneficial short‐term effects on both visual acuity and retinal thickness. Furthermore, combined therapies shows promising results. Despite promising early reports on the safety of these medications, the results of large, controlled trials are still expected in order to substantiate the safety and efficacy of anti‐VEGF drugs for diabetic retinopathy. Conclusion New therapeutic approaches based on intravitreal injections of anti‐VEGF molecules offer new hope for the management of diabetic macular edema. However, randomized studies are needed in order to attest longterm safety and efficacy profiles.