Diabetic macular edema (DME) is the most common retinopathy that seriously threatens the visual function of diabetic patients, and it represents a major cause of blindness especially among people in working age. Ocular VEGF inhibitors are most often used as a first line therapy for DME, and have revolutionary significance in improving visual outcomes. However, there remain 30%-50% patients who fail to respond to anti-VEGF treatment, and the need for frequent injections brings a substantial treatment burden to patients and society. Novel therapeutic strategies include improving efficacy and duration of anti-VEGF drugs, targeting inflammation, the plasma kallikrein-kinin system, the angiopoietin-Tie2 system, neurodegeneration and other alternative pathways, as well as using subthreshold and targeted laser therapy. It is still challenging in the individualized management of DME to identify non-responders to anti-VEGF drugs and to establish a standardized regimen for the switch from anti-VEGF therapy to anti-inflammatory or other alternative treatment. Further research and development of new therapies, as well as preventive and screening strategies, are needed to reduce the impact of diabetic retinopathy and DME on public health.

Macular edema/therapy; Diabetic retinopathy/complications; Editorial