Currently most common and most effective treatment approach for diabetic macular edema (DME) is intravitreal injection of anti-VEGF molecules, but this treatment modality exposes the patient to the risks of intra-ocular injections. At present intensive research works are going on to find out the non-invasive alternatives for the management of DME, and some of them are as follows:

Selective Protein Kinase C beta inhibitors [Ruboxistaurin]: As beta isoform of the enzyme PKC mediates many of the detrimental changes of the diabetes in the eyes, so Ruboxistaurin, a selective inhibitor of PKC beta has been developed, which has been shown to prevent many of the diabetes-induced changes in eye both in cell culture and in animal models. Phase 3 clinical trial of ORAL administration of Ruboxistaurin have demonstrated that it reduced the rate of sustained moderate vision loss (loss of 15 or more letters for at least two consecutive study visits) in eyes with definite diabetic macular edema at baseline (10% 32 mg/day study drug versus 25% placebo, P = 0.017). A separate study evaluated the ruboxistaurin specifically in regard to the reduction of progression of retinal thickening from more than 300 µ to within 100 µ of the center as measured in stereoscopic fundus photographs. The 32 mg/day dose reduced progression of DME compared to placebo (hazard ratio = 0.66 (95% CI 0.47-0.93 P = 0.016) (PKC-DMES Study Group, manuscript submitted). This product is currently under regulatory review for the treatment of early diabetic macular edema.

Topical Dexamethasone-Cyclodextrin Microparticle eye drops: M tanito et al conducted a short pilot study and found that topical Dexamethasone-Cyclodextrin eye drops decrease central macular thickness and increase visual acuity in DME patients.

Iontophoretic drug delivery is proposed as an alternative of a number of injections . It can be proposed that electrophoretic delivery of ranibizumab (Lucentis or other analogues) can be used in the future. Maybe it will interesting to read the following article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070845/

Currently most common and most effective treatment approach for diabetic macular edema (DME) is intravitreal injection of anti-VEGF molecules, but this treatment modality exposes the patient to the risks of intra-ocular injections. At present intensive research works are going on to find out the non-invasive alternatives for the management of DME, and some of them are as follows:

Selective Protein Kinase C beta inhibitors [Ruboxistaurin]: As beta isoform of the enzyme PKC mediates many of the detrimental changes of the diabetes in the eyes, so Ruboxistaurin, a selective inhibitor of PKC beta has been developed, which has been shown to prevent many of the diabetes-induced changes in eye both in cell culture and in animal models. Phase 3 clinical trial of ORAL administration of Ruboxistaurin have demonstrated that it reduced the rate of sustained moderate vision loss (loss of 15 or more letters for at least two consecutive study visits) in eyes with definite diabetic macular edema at baseline (10% 32 mg/day study drug versus 25% placebo, P = 0.017). A separate study evaluated the ruboxistaurin specifically in regard to the reduction of progression of retinal thickening from more than 300 µ to within 100 µ of the center as measured in stereoscopic fundus photographs. The 32 mg/day dose reduced progression of DME compared to placebo (hazard ratio = 0.66 (95% CI 0.47-0.93 P = 0.016) (PKC-DMES Study Group, manuscript submitted). This product is currently under regulatory review for the treatment of early diabetic macular edema.

Topical Dexamethasone-Cyclodextrin Microparticle eye drops: M tanito et al conducted a short pilot study and found that topical Dexamethasone-Cyclodextrin eye drops decrease central macular thickness and increase visual acuity in DME patients.