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Journal of Diabetes Research
Volume 2016, Article ID 2156273, 17 pages
Review Article

Diabetic Macular Edema Pathophysiology: Vasogenic versus Inflammatory

1Ophthalmology Service, University Hospital Sant Joan, Institut de Investigacio Sanitaria Pere Virgili (IISPV), University of Rovira & Virgili, Reus, Spain
2Department of Ophthalmology, Retina Section, Hospital Universitario de Canarias, Tenerife, Spain
3Department of Ophthalmology, University Hospital Valladolid, Ocular Diabetes Unit of IOBA, Valladolid, Spain

Received 31 May 2016; Revised 29 August 2016; Accepted 6 September 2016

Academic Editor: Goran Petrovski

Copyright © 2016 Pedro Romero-Aroca et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Diabetic macular edema (DME) can cause blindness in diabetic patients suffering from diabetic retinopathy (DR). DM parameters controls (glycemia, arterial tension, and lipids) are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF) is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease. However, it still remains to be clarified whether angiogenesis following VEGF overexpression is a cause or a consequence of inflammation. This paper provides a review of the data currently available, focusing on VEGF, angiogenesis, and inflammation. Our analysis suggests that angiogenesis and inflammation act interdependently during the development of DME. Knowledge of DME etiology seems to be important in treatments with anti-VEGF or anti-inflammatory drugs. Current diagnostic techniques do not permit us to differentiate between both etiologies. In the future, diagnosing the physiopathology of each patient with DME will help us to select the most effective drug.