Interventions for Diabetic Macular Oedema – a systematic review of the literature
- maeve o'doherty (maeveodoherty{at}gmail.com),
- Ian Dooley, Dr (iandooley55{at}hotmail.com),
- marie Hickey-Dwyer (mariehd1{at}hotmail.com)
- Limerick Regional Hospital, Republic of Ireland
- Limerick Regional Hospital, Republic of Ireland
- Limerick Regional Hospital, Republic of Ireland
- Published Online First 24 October 2008
Abstract
Objectives: In this review, we discuss the evolution of the treatment of diabetic macular oedema and give helpful guidelines in the treatment of diabetic macular oedema based on available evidence to date.
Methods: We performed a literature search of all English articles from the Medline and Cochrane database. We limited our search to only English randomized controlled clinical trials in humans. Overall, 93 articles were cited from 1979 to 2007. Of these 31 articles corresponded to subject matter.
Studies were evaluated on a standardized data extraction form and tabulated for easy review.
Results: There is good evidence that laser treatment preserves vision in eyes with Diabetic macular oedema (DMO). However, laser is a potentially destructive form of treatment which may be of greater benefit in combination with newer forms of treatment such as intravitreal steroid or intravitreal anti-angiogenic agents. Current evidence does not support a clear benefit for surgical intervention in DMO.
Conclusions: Although laser treatment remains the cornerstone of treatment in diabetic macular oedema we believe that the literature is beginning to support combination therapy. Using one or two intravitreal injections to reduce central macular thickness followed by focal or grid laser to give a sustained response may offer an alternative to treatment in DMO.
