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This abstract is assigned to session AOB FP

Title

Diabetic retinopathy: New treatment paradigms

Purpose	Diabetic retinopathy (DR) is the leading cause of vision loss in the population between 20 and 60 years old. Among these patients, visual impairment is often due to diabetic macular edema (DME). This paper summarizes data from clinical trials that investigated anti-VEGF, for the management of DME and evaluates their impact on clinical practice.
Methods	Data from diabetic retinopathy clinical research network,search from 2013 onwards, concerning the use of laser, anti-VEGF and steroids in the management of DME were summarized.
Results	Laser treatment alone has a lower efficacy if compared with anti-VEGF therapy, but may reduce the number of injection. With anti-VEGF treatment visual acuity may improve and retinal thickness diminishes. Steroids are nearly as efficient as anti-VEGF in reducing macular edema but give rise to side effects like cataract and ocular hypertension. The use of steroids in combination with anti-VEGF seems no better than either one alone.
Conclusion	Anti-VEGF treatment may be indicated if the initial visual acuity is better than 20/200 with an average loading phase of 5 consecutive injections. In a visual acuity less than 20/50 aflibercept was proven most effective. Laser treatment may still be considered in vasogenic subforms of ischemic diabetic macular edema or DME with a central retinal thickness less than 300µm. Corticosteroids are more suitable as a second line therapy, indicated in anti-VEGF non responders,or as first choice in cardiovascular compromised patients. Among eyes with proliferative diabetic retinopathy visual acuity with anti-VEGF was found to be no less than after laser treatment.
Conflict of interest	No

Authors 1

Last name	FASOLINO
Initials	G
Department	UZBRUSSEL
City	BRUSSEL

Authors 2

Last name	APPELTANS
Initials	A
Department	UZBRUSSEL
City	BRUSSEL

Authors 3

Last name	TEN TUSSCHER
Initials	M
Department	UZBRUSSEL
City	BRUSSEL

Authors 4

Last name	CORNELISSEN
Initials	P
Department	uzbrussel
City	brussel