1. Sustained-release steroids for the treatment of diabetic macular edema
- Author
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Francine Behar-Cohen, Alexandre Matet, and Alejandra Daruich
- Subjects
Glucocorticoids/therapeutic use ,Intraocular pressure ,medicine.medical_specialty ,Diabetes Complications/metabolism ,genetic structures ,Endocrinology, Diabetes and Metabolism ,Macular Edema/etiology ,Pharmacology ,Macular Edema ,law.invention ,Macular Edema/metabolism ,Diabetes Complications ,Fluocinolone acetonide ,Randomized controlled trial ,law ,Diabetes mellitus ,Ophthalmology ,Internal Medicine ,medicine ,Animals ,Humans ,Adverse effect ,Macular edema ,Glucocorticoids ,Dexamethasone ,Steroids/metabolism ,Clinical Trials as Topic ,business.industry ,Therapeutic effect ,Macular Edema/drug therapy ,medicine.disease ,eye diseases ,Treatment Outcome ,Delayed-Action Preparations ,Diabetes Complications/drug therapy ,Steroids ,sense organs ,business ,medicine.drug - Abstract
Glucocorticoids have been used for decades in the treatment of ocular disorders via topical, periocular, and more recently intravitreal routes. However, their exact mechanisms of action on ocular tissues remain imperfectly understood. Fortunately, two recently approved intravitreal sustained-release drug delivery systems have opened new perspectives for these very potent drugs. To date, among other retinal conditions, their label includes diabetic macular edema, for which a long-lasting therapeutic effect has been demonstrated both morphologically and functionally in several randomized clinical trials. The rate of ocular complications of intravitreal sustained-release steroids, mainly cataract formation and intraocular pressure elevation, is higher than with anti-vascular endothelial growth factor agents. Yet, a better understanding of the mechanisms underlying these adverse effects and the search for the minimal efficient dose should help optimize their therapeutic window.
- Published
- 2015