New Diagnostic and Therapeutic Approaches for Preventing the Progression of Diabetic Retinopathy

Table 1

Summary of current ophthalmic therapeutic options for diabetic macular edema.

Category	Previous treatment options	New treatments options	Benefits of new treatments
Laser photocoagulation	Pan retinal photocoagulation; Focal photocoagulation	Pattern scan laser (Pascal); Subthreshold diode micropulse laser (SDM); Retinal rejuvenation therapy (2RT); Selective retina therapy (SRT)	It reduces laser-induced side effects; (constriction of visual fields, reduced dark adaption, and reduced color and contrast perception)
Anti-VEGF agent	Pegaptanib (Macugen); Ranibizumab (Lucentis); Bevacizumab (Avastin); Aflibercept (Eylea)	Anti-VEGF agents plus focal/grid laser therapy	(i) Intravitreal anti-VEGF therapy is generally safer; (ii) Visual acuity could be maintained with tapering the injection frequency over time
Steroid	Intravitreal triamcinolone acetonide	Dexamethasone sustained-release intravitreal implant (Ozurdex); Fluocinolone acetonide implant (Retisert)	(i) It Reduces the frequency of intravitreal anti-VEGF injections; (ii) It is less associated with cataract formation and increased intraocular pressure than the previous steroid agents
Surgical treatment	Conventional 20-gauge vitrectomy	Transconjunctival sutureless 23- or 25-gauge vitrectomy	It reduced surgery times and makes rehabilitation of patients faster