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REVIEW ARTICLE
Year : 2016  |  Volume : 64  |  Issue : 1  |  Page : 14-25

Evidence-based review of diabetic macular edema management: Consensus statement on Indian treatment guidelines


1 L. V. Prasad Eye Institute, Hyderabad, Telangana, India
2 Delhi Retina Center, New Delhi, India
3 Giridhar Eye Institute, Kochi, Kerala, India
4 RP Centre for Ophthalmic Sciences, New Delhi, India
5 Sankara Nethralaya, Chennai, Tamil Nadu, India
6 Retina Foundation, Ahmedabad, Gujarat, India
7 Aditya Jyot Eye Hospital, Mumbai, Maharashtra, India
8 Aravind Eye Care System, Madurai, Tamil Nadu, India
9 Centre for Sight, New Delhi, India

Correspondence Address:
Taraprasad Das
L. V. Prasad Eye Institute, Banjara Hills, Hyderabad - 500 034, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.178142

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The purpose of the study was to review the current evidence and design a diabetic macular edema (DME) management guideline specific for India. The published DME guidelines from different organizations and publications were weighed against the practice trends in India. This included the recently approved drugs. DME management consisted of control of diabetes and other associated systemic conditions, such as hypertension and hyperlipidemia, and specific therapy to reduce macular edema. Quantification of macular edema is precisely made with the optical coherence tomography and treatment options include retinal laser, intravitreal anti-vascular endothelial growth factors (VEGF), and implantable dexamethasone. Specific use of these modalities depends on the presenting vision and extent of macular involvement. Invariable eyes with center-involving macular edema benefit from intravitreal anti-VEGF or dexamethasone implant therapy, and eyes with macular edema not involving the macula center benefit from retinal laser. The results are illustrated with adequate case studies and frequently asked questions. This guideline prepared on the current published evidence is meant as a guideline for the treating physicians.


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