Faghihi Shahin, Faghihi Hooshang, Faiez Mir Alborz, Mohammadi Abbas, Asadi Khameneh Esmaeil, Khalili Pour Elias, Riazi-Esfahani Hamid
Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Faculty of Medicine, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.
J Curr Ophthalmol. 2025 Jun 5;36(3):229-241. doi: 10.4103/joco.joco_133_24. eCollection 2024 Jul-Sep.
To comprehensively review and evaluate the therapeutic strategies for persistent diabetic macular edema (DME), with a particular emphasis on established treatments. Furthermore, the study explores emerging and innovative therapeutic options.
A nonsystematic search was carried out using PubMed, Cochrane, Medline, and Google Scholar databases with the keywords "macular edema", "persistent", "diabetic", "therapeutic", and "emerging". We specifically looked for experimental studies, randomized clinical trials, and retrospective and prospective studies without limiting the search timeframe for the articles up to December 2023.
This review delineates a comprehensive array of treatment modalities for persistent DME, encompassing anti-vascular endothelial growth factor (anti-VEGF) switching, corticosteroids, laser therapies, combination therapy, and surgical approaches. Additionally, emerging treatments were explored, featuring novel anti-VEGF agents, innovative surgical techniques, as well as inhibitors targeting Angiopoietin-2 and the Kallikrein-Kinin System.
It is important to employ personalized and evidence-based approaches in addressing persistent DME. The ongoing advancement in treatment paradigms will play a crucial role in the continual evolution of DME management.
全面回顾和评估持续性糖尿病黄斑水肿（DME）的治疗策略，特别强调已确立的治疗方法。此外，本研究还探索新兴和创新的治疗选择。
使用PubMed、Cochrane、Medline和谷歌学术数据库进行非系统性检索，关键词为“黄斑水肿”、“持续性”、“糖尿病”、“治疗”和“新兴”。我们专门查找实验研究、随机临床试验以及回顾性和前瞻性研究，对截至2023年12月的文章不限制检索时间范围。
本综述阐述了一系列针对持续性DME的治疗方式，包括抗血管内皮生长因子（抗VEGF）转换、皮质类固醇、激光治疗、联合治疗和手术方法。此外，还探索了新兴治疗方法，包括新型抗VEGF药物、创新手术技术以及靶向血管生成素-2和激肽释放酶-激肽系统的抑制剂。
采用个性化和循证方法处理持续性DME很重要。治疗模式的不断进步将在DME管理的持续发展中发挥关键作用。
