Statement of the German Ophthalmological Society, the German Retina Society, and the Professional Association of Ophthal
- PDF / 2,532,987 Bytes
- 28 Pages / 595 x 792 pts Page_size
- 33 Downloads / 216 Views
German Society of Ophthalmology (DOG)1 · German Retina Society (RG)2 · Professional Association of Ophthalmologists in Germany (BVA)3 1
© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
Deutsche Ophthalmologische Gesellschaft (DOG), Munich, Germany Retinologische Gesellschaft e. V. (RG), Freiburg, Germany 3 Berufsverband der Augenärzte Deutschlands e. V. (BVA), Düsseldorf, Germany 2
Statement of the German Ophthalmological Society, the German Retina Society, and the Professional Association of Ophthalmologists in Germany on treatment of diabetic macular edema Dated August 2019
Key messages
(and morphological) status can be expected on the basis of findings. Grade of recommendation: ⇑⇑
Recommendations/statements 1.1 Indication
2.1 Treatment selection: Diabetic macular edema with foveal involvement
4 To determine the treatment indi-
cation of diabetic macular edema (DME), the following examinations should be performed as a minimum: assessment of best-corrected visual acuity, slit-lamp examination of the anterior eye segment (for, e.g., neovascularization of the iris), stereoscopic dilated examination of the entire retina, fluorescein angiography (FA), optical coherence tomography (OCT). Grade of recommendation: ⇑⇑ 4 Diabetic macular edema should only be treated using intravitreal drugs if a positive effect on functional
The German version of this article can be found under https://doi.org/10.1007/s00347019-01015-2.
4 If there is foveal involvement in
diabetic macular edema, there are a number of possible treatment modalities that the patient should be informed about regarding the respective prognosis of visual acuity and the frequency of treatments, as well as potential complications: a. intravitreal anti-VEGF (anti vascular endothelial growth factor) therapy, b. intravitreal steroid therapy, c. focal/grid laser therapy. Grade of recommendation: ⇑ 4 In the case of macular edema with foveal involvement and impaired vision, intravitreal injections should primarily be performed if the morphological findings suggest a min-
imum prognosis of 20/400 (lower limit of visual acuity: 20/400). Grade of recommendation: ⇑⇑ 4 For intravitreal injection therapy, the side effects profile of the drugs should be taken into account. The higher rate of ocular adverse events following intravitreal steroids (increased intraocular pressure, cataract formation) supports the use of VEGF inhibitors; the lower number of injections supports the use of depot steroids. Grade of recommendation: ⇑⇑
2.1-1 Intravitreal injection therapy with VEGF inhibitors 4 The three commonly used VEGF
inhibitors, aflibercept, ranibizumab, and bevacizumab, show good efficacy. Ranibizumab and aflibercept have received drug approval. The use of bevacizumab represents an off-label treatment, as does the use of certain compounded original drugs. Grade of recommendation: Statement 4 To date, only scant data are available for a comparative assessment of the Der Ophthalmologe
Leitlinien, Stellungnahmen und Empfehlungen three VEGF inhibitors. There is
Data Loading...
