Trends in treating chronic persistent diabetic macular edema

Chronic persistent diabetic macular edema responds poorly to intravitreal Anti VEGF treatment due to dominance of inflammatory cytokines in the pathogenesis optical coherence tomography is important tool to evaluate structural changes and visual prognosis in diabetic macular edema Multiple studies showed the efficacy of intravitreal steroids treatment and intravitreal Anti VEGF agents may reduce the risk of visual loss in cases of chronic persistent diabetic macular edema When optical coherence tomography shows signs of disorganization of inner retinal layer and interruption of ellipsoid zone in light of diabetic macular edema that responds poorly to Anti VEGF treatment then switching to intravitreal steroids recommended