Diabetic Macular Oedema Guidelines: An Australian Perspective

Yew Sen Yuen; Jagjit Singh Gilhotra; Michelle Dalton; Jaskirat S Aujla; Hemal Mehta; Sanj Wickremasinghe; Gurmit Uppal; Jennifer Arnold; Fred Chen; Andrew Chang; Samantha Fraser-Bell; Lyndell Lim; Janika Shah; Ellie Bowditch; Geoffrey K Broadhead

doi:10.1155/2023/6329819

Diabetic Macular Oedema Guidelines: An Australian Perspective

J Ophthalmol. 2023 Feb 14:2023:6329819. doi: 10.1155/2023/6329819. eCollection 2023.

Authors

Yew Sen Yuen¹, Jagjit Singh Gilhotra², Michelle Dalton³, Jaskirat S Aujla⁴, Hemal Mehta^{5

6}, Sanj Wickremasinghe⁷, Gurmit Uppal⁸, Jennifer Arnold⁹, Fred Chen^{10

11}, Andrew Chang^{12

13

14}, Samantha Fraser-Bell¹⁵, Lyndell Lim⁷, Janika Shah^{16

17}, Ellie Bowditch¹⁴, Geoffrey K Broadhead¹⁴

Affiliations

¹ National University Hospital, Singapore.
² Royal Adelaide Hospital, Adelaide, Australia.
³ Dalton & Associates Inc., Pennsylvania, USA.
⁴ South Australian Institute of Ophthalmology, Adelaide, SA, Australia.
⁵ Save Sight Registries, University of Sydney, Sydney, NSW, Australia.
⁶ Strathfield Retina Clinic, Sydney, Australia.
⁷ Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.
⁸ Moreton Eye Group, Brisbane, Queensland, Australia.
⁹ Marsden Eye Specialists, Sydney, NSW, Australia.
¹⁰ Centre for Ophthalmology and Visual Sciences (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia.
¹¹ Ophthalmology, Department of Surgery, University of Melbourne, Victoria, Australia.
¹² Sydney Institute of Vision Science, University of Sydney, Sydney, NSW, Australia.
¹³ Sydney Retina Clinic and Day Surgery, University of Sydney, Sydney, NSW, Australia.
¹⁴ Save Sight Institute, University of Sydney, Sydney, NSW, Australia.
¹⁵ Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia.
¹⁶ Sydney Eye Hospital, Sydney, Australia.
¹⁷ Singapore National Eye Centre, Singapore.

Abstract

The number of people living with diabetes is expected to rise to 578 million by 2030 and to 700 million by 2045, exacting a severe socioeconomic burden on healthcare systems around the globe. This is also reflected in the increasing numbers of people with ocular complications of diabetes (namely, diabetic macular oedema (DMO) and diabetic retinopathy (DR)). In one study examining the global prevalence of DR, 35% of people with diabetes had some form of DR, 7% had PDR, 7% had DMO, and 10% were affected by these vision-threatening stages. In many regions of the world (Australia included), DR is one of the top three leading causes of vision loss amongst working age adults (20-74 years). In the management of DMO, the landmark ETDRS study demonstrated that moderate visual loss, defined as doubling of the visual angle, can be reduced by 50% or more by focal/grid laser photocoagulation. However, over the last 20 years, antivascular endothelial growth factor (VEGF) and corticosteroid therapies have emerged as alternative options for the management of DMO and provided patients with choices that have higher chances of improving vision than laser alone. In Australia, since the 2008 NHMRC guidelines, there have been significant developments in both the treatment options and treatment schedules for DMO. This working group was therefore assembled to review and address the current management options available in Australia.

Publication types

Review