Biologic Therapy and Treatment Options in Diabetic Retinopathy with Diabetic Macular Edema

Proliferative diabetic retinopathy and diabetic macular edema can be a potentially sight-threatening disease if not treated correctly. It is directly correlated to the duration of diabetes, and how well managed the patients diabetes is. In the last 15 years, the treatment of diabetic eye disease has taken a quantum leap in methodology due to the group of biological agents named anti-vascular endothelial growth factor (anti-VEGF). The introduction of the first biological agent has revolutionized the treatment, not only in diabetic eye disease but also across most inflammatory eye diseases causing leakage of fluid from the blood vessels i.e. age-related macular degeneration. The availability of these biological agents despite their considerable costs have significantly improved the outcome measured in visual acuity compared to more traditional treatment of diabetic retinopathy in the form of sole laser treatment and glycemic control. The agents demonstrate a favorable safety profile, but if the rarest and most severe side effect occurs, there is a potential total loss of vision. This review aims to make an overview of the current pharmaceutical therapeutic options in the treatment of diabetic macular edema. This includes laser therapy, intravitreal steroids and with a primary focus on intravitreal anti-vascular endothelial growth factors.