Diabetic macular edema (DME) is a common consequence of diabetic retinopathy and a leading cause of significantly impaired vision among patients with diabetes. For many years, the standard of care has been to treat DME with laser photocoagulation treatments to the macula. Recently, evidence has begun to accumulate demonstrating the effectiveness of injectable intravitreal drugs that inhibit vascular endothelial growth factor (VEGF). Although none of these agents has yet received Food and Drug Administration approval for this indication, off-label use is substantial. The objective of this review was to assess the clinical effectiveness and potential harms of all available anti-VEGF drugs: pegaptanib (Macugen), bevacizumab (Avastin), ranibizumab (Lucentis), and aflibercept (Eylea).
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