Table 3 Comparisons between the current study recommendations and national guidelines for different clinical situations for diabetic macular edema management
Category | Clinical situation | Current study recommendations | AIOS-DR Task Force and VRSI recommendations |
|---|---|---|---|
DME status | No DME (n = 20) | Observation | Observation |
NCIDME (n = 8) | Observation | Observation | |
Treatment naïve CIDME (n = 11) | IVA | Observation for eyes with very good VA IVA for VA < 20/30 | |
Previously treated CIDME (n = 11) | IVA or IVS | IVA | |
CIDME with co-existing ocular co-morbidity | CIDME with proliferative DR (n = 6) | IVA | IVA |
CIDME with pseudophakia (n = 6) | IVS | IVA or IVS or topical steroids | |
CIDME with cataract (n = 10) | IVA | IVA with or without cataract surgery | |
CIDME with glaucoma (n = 0) | Cannot be commented upon | Avoid IVS | |
CIDME with LD (n = 2) | IVA or IVS without prophylactic barrage to the LD | Prophylactic barrage to the LD first followed by IVA or IVS after 3 weeks | |
CIDME in vitrectomised eye (n = 1) | IVS | IVA or IVS | |
CIDME with co-existing systemic co-morbidity | CIDME with uncontrolled diabetes (n = 15) | IVA or IVS irrespective good metabolic control | IVA or IVS with good metabolic control |
CIDME with renal disease and anemia (n = 11) | IVA | Controversial role of IVA | |
CIDME with hypertension (n = 18) | IVA or IVS | IVA with good control of blood pressure | |
CIDME with pregnancy (n = 5) | Macular laser or IVS | Observation or focal laser or IVS. Avoid IVA | |
CIDME with history of CVD within 3 months (n = 3) | IVA | Avoid IVA |