Pathophysiology of diabetic macular edema – a background for current treatment modalities

ABSTRACTIntroduction: Diabetic macular edema is a sight-threatening disease and a major cause for blindness for people in working age. The pathogenesis or pathophysiology of this condition is multifactorial and different pathways have been identified, such as inflammation, the modulation of vascular integrity and tractional forces at the vitreomacular interface. Considering the significance of these pathogenetic mechanisms as the main targets in the modern treatment of diabetic macular edema, the current review aims to provide a detailed insight in the current understanding regarding these pathways.Areas covered: This review discusses original research articles including basic science and clinical studies as well as review articles focusing on inflammation, the vascular endothelial growth factor (VEGF) pathway and the role of the vitreomacular interface. The literature was searched using Medline/PubMed and articles were selected given their relevance for the topic to be discussed.Expert commentary: In rec...