Healio Diabetic Macular Edema: Rethinking Response and Revising Treatment With Corticosteroid Therapy

Despite major therapeutic advances, diabetic macular edema (DME) remains a leading cause of vision loss in adults with diabetes, with delayed diagnosis, treatment burden, and suboptimal responses continuing to challenge real-world outcomes. Although intravitreal anti-vascular endothelial growth factor (VEGF) therapy is the established first-line standard of care, many patients experience persistent or refractory DME, and long-term visual gains in routine practice often fall short of results seen in clinical trials due to undertreatment and adherence challenges. Early identification of inadequate treatment response and timely therapy modification are critical, as untreated or insufficiently treated DME can result in significant, irreversible vision loss. Emerging evidence supports the use of newer anti-VEGF agents with extended dosing intervals, as well as the early integration of corticosteroid implants for patients with suboptimal responses. Corticosteroid therapies offer broad anti-inflammatory benefits and have demonstrated meaningful visual and anatomical improvements, particularly when introduced earlier in the disease course. In this CE Snips activity, expert faculty assess how to recognize when patients with DME demonstrate insufficient response to anti-VEGF therapy and when to integrate corticosteroid therapy based on current clinical evidence and real-world data.