Table 4.
Advantages and disadvantages of different therapies for diabetic macular edema
| Advantages | Disadvantages | |
|---|---|---|
| Photocoagulation | Low risk of complications | Many patients do not respond |
| Well-studied | ||
| Inexpensive | ||
| Triamcinolone | Efficacy well-established | Many patients do not respond |
| Inexpensive | High rate of cataract progression | |
| High rate of increased IOP | ||
| Regular injections and follow-up | ||
| Dexamethasone | Decreased follow-up | High rate of cataract progression |
| High rate of increase IOP | ||
| Not well-studied in DME | ||
| Anti-VEGF therapy | Very strong efficacy | Regular injections and follow-up |
| Most patients responsive | ||
| Well-studied | ||
| Vitrectomy | Effective in patients with poor VA | Efficacy not well-established |
| Requires procedure in operating room | ||
| FAc implant | Strong efficacy | Very high rate of cataract progression |
| Decreased follow-up | High rate of increased IOP | |
| Increased risk for IOP-lowering surgery | ||
| Requires procedure in the operating room | ||
| FAc insert | Strong efficacy | Very high rate of cataract progression |
| Decreased follow-up | High rate of increased IOP | |
| Increased risk for IOP-lowering surgery |
Abbreviations: DME, diabetic macular edema; FAc, fluocinolone acetonide; IOP, intraocular pressure; VA, visual acuity; VEGF, vascular endothelial growth factor.