systematic review of the literature Interventions for diabetic macular oedema: a

ABSTRACTObjectives: This review discusses the evolution of thetreatment of diabetic macular oedema and gives helpfulguidelines in the treatment of diabetic macular oedemabased on available evidence to date.Methods: A literature search of all English articles fromthe Medline and Cochrane database was performed. Thesearch was limited to only English randomised controlledclinical trials in humans. Overall, 93 articles were citedfrom 1979 to 2007. Of these, 31 articles correspondedto subject matter. Studies were evaluated on astandardised data extraction form and tabulated for easyreview.Results: There is good evidence that laser treatmentpreserves vision in eyes with diabetic macular oedema(DMO). However, laser is a potentially destructive form oftreatment which may be of greater benefit in combinationwith newer forms of treatment such as intravitreal steroidor intravitreal antiangiogenic agents. Current evidencedoes not support a clear benefit for surgical intervention inDMO.Conclusions: Although laser treatment remains thecornerstone of treatment in diabetic macular oedema, theliterature is beginning to support combination therapy.Using one or two intravitreal injections to reduce centralmacular thickness followed by focal or grid laser to give asustained response may offer an alternative to treatmentin DMO.Diabetes mellitus affects 200 million people in theworld.