What is the best anti-vascular endothelial growth factor agent for the treatment of diabetic macular edema? Review of the 2-year results of Diabetic Retinopathy Clinical Research Network Protocol T

Diabetic macular edema (DME) remains a main concern in diabetic patients, due to potential visual impairment with any level of diabetic retinopathy. The first study to provide a treatment option for these patients was The Early Treatment Diabetic Retinopathy Study (ETDRS), using laser therapy to reduce moderate vision loss by approximately 50% in patients defined as having clinically significant macular edema (1). Despite the fact that prevention of visual loss is crucial, visual improvement is another important goal. Therefore, the focus of research in the past years has been shifted to the use of anti-vascular endothelial growth factor (VEGF) therapy to treat DME, with focal laser no longer considered as first line therapy. With excellent results reported in previous studies, and only rare adverse events, it is becoming clearer that anti-VEGF therapy will play an increasing role in DME treatment.