Treatment choices for diabetic macular oedema: a guideline for when to consider an intravitreal corticosteroid, including adaptations for the COVID-19 era
Type of article: Clinical Article Summary
MedED Catalogue Reference: MOT003
Compiler: Linda Ravenhill
Sources: BMJ Open Ophthalmology
This guideline, published BMJ Opthalmology Open in April 2021, contains a review by eight retina specialists who initial convened to discuss how to ensure eyes with CI-DMO receiving intravitreal anti-VEGF therapy are evaluated for a potential change to intravitreal corticosteroid therapy at the most effective time in their treatment journey.
First-line treatment of centrally involved diabetic macular oedema (CI-DMO) often involves an anti-vascular endothelial growth factor (anti-VEGF) agent. Changing treatment to an intravitreal corticosteroid implant at the appropriate time may help optimise patient outcomes and reduce injection frequency, thereby decreasing the treatment burden.
They concluded that there was a requirement to develop clear criteria for when to consider changing treatments. They, therefore, developed a consensus guideline covering key decision points such as when and how to assess response to anti-VEGF therapy, when to consider a change to corticosteroid therapy, and when and how to assess the response to corticosteroid therapy.
The guideline was developed before the COVID-19 pandemic. However, the publication also includes suggestions for adapting the guidelines in the COVID-19 era.
These guidelines are made available here under the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license on the basis that this work is not used for commercial gain.
Treatment choices for diabetic macular oedema: a guideline for when to consider an intravitreal corticosteroid, including adaptations for the COVID-19 era 
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Linda Ravenhill is a medical professional with an MA in Journalism. She has worked in the medical, technology and digital development spaces for over 25 years, & has a particular interest in the impact of technology on the delivery of healthcare in the Sub-Saharan Africa region.
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