Diabetic Macular Edema Management: A Review of Anti-Vascular Endothelial Growth Factor (VEGF) Therapies

Abstract

Diabetic macular edema (DME) is a major cause of vision impairment in diabetic individuals, characterized by fluid accumulation in the macula due to a breakdown of the blood-retinal barrier (BRB). This review article explores the role of anti-vascular endothelial growth factor (anti-VEGF) therapies in the management of DME. Anti-VEGF treatments, including ranibizumab, bevacizumab, and aflibercept, have revolutionized DME management by targeting VEGF, a key mediator in DME pathogenesis. We critically examined the efficacy of these therapies in reducing macular edema and improving visual acuity, assessed their safety and tolerability, and explored the variability in treatment response. The review highlights the latest advancements and future directions in anti-VEGF therapy, including novel drug delivery systems and emerging treatment paradigms. By providing a comprehensive overview of current anti-VEGF therapies, this review seeks to inform clinical practice, guide future research, and contribute to improved patient outcomes in DME management.

Keywords: aflibercept; anti-vegf injections; anti-vegf treatment; diabetic retinopathy; intravitreal bevacizumab; intravitreal ranibizumab; medical retina and glaucoma; review article.

Figure 1. Efficacy and safety outcomes of ranibizumab therapy in diabetic macular edema

Graph A: visual acuity gain. Graph B: change in retinal thickness. Graph C: adverse event rate This figure was produced by the authors using data from the study mentioned above [29,30].

Figure 2. Comparative analysis of aflibercept, bevacizumab, and ranibizumab

Graph A: visual acuity improvement. Graph B: treatment frequency and additional interventions. Graph C: adverse events. This figure was produced by the authors using data from the study mentioned above [43–45].