The prevalence of diabetes mellitus worldwide is increasing, in part due to an obesity epidemic. Thus, prevention and treatment of vision loss from diabetic retinopathy, including proliferative diabetic retinopathy and diabetic macular edema (DME), has become more important.1 Diabetic macular edema, a swelling of the central part of the macula (Figure), affects approximately 746 000 adults aged 40 years or older in the United States (approximately 4% with diabetes develop DME).2
A, Intravitreal ranibizumab for diabetic macular edema with prompt versus deferred laser treatment.5,6 Visual acuity change from baseline among 4 groups randomized to receive prompt focal/grid laser plus a sham intravitreal injection, prompt laser plus intravitreal ranibizumab, deferred laser (for at least 24 weeks) plus intravitreal ranibizumab, or prompt laser plus intravitreal corticosteroids through 2 years with a 3-year comparison of the 2 ranibizumab groups. B, Fundus photograph of case with diabetic macular edema. Circle indicates lipid, ie, hard exudates, near the center of the macula.
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