Steroids and the Management of Macular Edema

Abstract

Macular edema (ME) is a condition which is usually secondary to an underlying disease process. It is most commonly seen following venous occlusive disease, diabetic retinopathy and posterior segment inflammatory disease. The treatment of ME varies, depending upon the underlying etiology, and has led to varying degrees of success. Traditionally, the main treatment options have included topical and systemic steroids, due to their known antiangiogenic, antiedematous, antiinflammatory and antiproliferative effects. This comprehensive review outlines the current use of steroids and highlights the ever-growing indications for steroids in ME secondary to various ocular conditions as well as the recent breakthrough results of the efficacy of this treatment.

Comparison of the intraocular pressure following an intravitreal triamcinolone acetonide injection for diabetic macula oedema in vitrectomised and non-vitrectomised eyes

“…4 5 As VEGF inhibitors reduce the excess vascular permeability by acting on VEGF, corticosteroids act on several pathways involved in the DME pathogenesis to inhibit the inflammatory cytokines including VEGF. 6 Corticosteroids are non-specific anti-inflammatory agents and have also been reported to antagonise the action of VEGF. 7 8 The effect of three potent corticosteroids, that is, triamcinolone acetonide (TA), fluocinolone acetonide and dexamethasone, was found as treatments for DME.…”

Intravitreal Corticosteroids in the Management of Diabetic Macular Edema

“…16 Corticosteroids are powerful non-specific anti-inflammatory agents and have also been reported to antagonize the action of VEGF. 17,18 Data available to date suggest that corticosteroids are most effective against DME when delivered intravitreally.…”