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Invited Commentary
March 2018

Anti–Vascular Endothelial Growth Factor Therapy in Diabetic Macular Edema: Does Flavor Matter?

Author Affiliations
  • 1Washington University School of Medicine, St Louis, Missouri
JAMA Ophthalmol. 2018;136(3):269-270. doi:10.1001/jamaophthalmol.2017.6559

Macular edema is the most common cause of vision loss in diabetes.1 Intravitreal vascular endothelial growth factor (VEGF)–targeted therapy for diabetic macular edema (DME) leads to sustained visual and anatomic gains in well-designed randomized clinical trials.2 Despite these advances, persistent DME (pDME) at 24 weeks after anti-VEGF therapy and chronic, persistent DME (cpDME) at 2 years after initiation of treatment is a significant problem. An exploratory analysis by the Diabetic Retinopathy Clinical Research Network demonstrated cpDME in 40% of participants at 3 years after anti-VEGF therapy with ranibizumab despite adherence to DRCR-retreatment protocols. The study also showed that despite persistent edema, visual outcomes were excellent in most patients.3,4