Use of anti-vascular endothelial growth factor drugs for diabetic macular edema

Diabetic macular edema (DME) represents the most common cause of vision loss in patients affected by diabetes mellitus. Diabetic retinopathy has a significant impact on public health and the quality of life of many patients, and thus requires noteworthy consideration. The first line of treatment remains the management of systemic risk factors, but is often insufficient in controlling DME. For 25 years, the focal/grid laser photocoagulation was considered the standard of care for DME. Laser treatment reduces the risk of moderate visual loss by approximately 50%, but it is not associated with remarkable effects on visual improvement. Lately, new approaches in the treatment of DME have been considered; in particular the employment of anti-vascular endothelial growth factor (anti-VEGF) drugs. VEGF is a pluripotent growth factor that functions as a vasopermeability factor and an endothelial cell mitogen, and thereby represents an appealing candidate as a therapeutic target for the treatment of DME. Recent trials have been investigating many anti-VEGF agents in the treatment of DME. The goal of this review is to present the evidence behind the use of anti-VEGF drugs in the treatment of DME.