Management Strategies in Diabetic Macular Edema

Diabetic Macular Edema (DME), a micro vascular complication of diabetes mellitus accounts for three quarter of cases of moderate visual loss due to diabetic eye disease. This entity represents a significant burden with increasing incidence and prevalence of diabetes in the Indian subcontinent, and availability of limited public health resources. In chronic poorly controlled diabetics with associated co–morbid conditions such as dyslipidemias and overt nephropathy, the edema at the macula tends to be more severe, and is characterized by the accumulation of plaques of hard exudates under the fovea, exhibiting poor response to conventional therapies and showing a tendency to becoming recalcitrant. In this situation the patient is burdened by severe visual loss, with very few management options and a poor visual prognosis. Yet DME still remains an underestimated complication of diabetes 1 primarily due to lack of awareness among the patients and primary care physicians alike.