ABSTRACT
Diabetic macular edema (DME) is an important cause of vision loss and is estimated to occur in 29% of patients who have had diabetes for 20 years or more. Diabetes mellitus is a group of metabolic diseases characterized by an increased blood glucose level secondary to defects in insulin secretion and/or action. Corticosteroids have antiangiogenic, antifibrotic, and antipermeability properties that help to stabilize the blood–retinal barrier, aid in exudation resorption, and downregulate inflammatory mediators. Retinal microvascular basement membrane thickening and a reduced number of pericytes further contribute to increased retinal vessel permeability. The study demonstrated that retinal edema at the center of the macula had resolved completely in 53.7% of eyes in the fluocinolone group compared with 28.6% of eyes in the standard of care group. Plasminogen kringle 5, an angiogenic inhibitor, blocks retinal neovascularization in oxygen-induced retinopathy models. DME is a result of blood–retinal barrier breakdown.
