Les traitements intravitréens de la rétinopathie diabétique

Diabetic retinopathy is the first cause of blindness among patients under 50 years. Significant progress has been made in treating the complications of diabetic retinopathy, including diabetic macular edema. Bevacizumab is used off-label in addition to laser in proliferative retinopathy and improves its prognosis. Ranibizumab is effective in improving visual acuity in diabetic macular edema, and has obtained a marketing authorization (MA) in this indication, but at the cost of repeated injections and monthly follow-ups. Injections of intravitreal triamcinolone acetonide are also effective in macular edema but have significant corticosteroid-adverse reactions and no MA for intraocular use. Laser therapy can still be used alone or in adjunction to intravitreal injections, in certain types of macular edemas, with a slow but long-term durable efficacy.