Update on anti-vascular endothelial growth factor treatment for diabetic macular edema

Diabetic macular edema (DME) is a severe, sight-threatening condition.It mainly presents as retinal thickening and hard exudates caused by the accumulation of extracellular fluid within the diameter of the optic disc in the macula fovea caused by chronic hyperglycemia.The pathogenesis of DME is a complex process involving various contributing factors, with the elevated release of vascular endothelial growth factor (VEGF) being one of the important reasons.Anti-VEGF drugs, including pegaptanib sodium, bevacizumab, ranibizumab, aflibercept, conbercept, and brolucizumab, are the first-line therapy for treating DME due to the satisfying efficacy and safety demonstrated in numerous clinical studies.For refractory DME, timely switching to different anti-VEGF drugs or adopting corticosteroid-based treatments appears promising.Although the compliance and cost-effectiveness of anti-VEGF drugs may be a heavy burden for DME patients, pro re nata and treat & extend strategy might help.With the rapid development of the pharmaceutical industry, new anti-VEGF drugs (such as faricilumab and IBI-302) may offer broader therapeutic prospects for treating DME.This article reviews updates on anti-VEGF treatment for DME.

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