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Diabetic macular edema (DME) is a common complication of diabetic
retinopathy (1). Vision loss in patients with diabetes is often associated
with diabetic macular edema, DME. Even though DME is a chronic condition,
appropriate use of available effective treatment modalities of therapy can
be used to prevent moderate and severe vision loss from DME (1).
"Despite the current wider spectrum of treatments for Diabetic...
"Despite the current wider spectrum of treatments for Diabetic
Macular Edema (DME), only a small proportion of patients recover good
vision (20/40)"(2). Authors of this systematic review on current
treatment modalities of therapy suggested that the most of DME patients
would not achieve the 20/40 visual acuity required for driving. Therefore the authors proposed more effective treatments or combinations of treatments
in order to achieve the 20/40 visual acuity (2).
The Diabetic Retinopathy Clinical Research Network (DRCR.net) has
recently published a study that shows the efficacy of the intravitreal
anti-vascular endothelial growth factor (VEGF) agent ranibizumab on
driving (3). The study result suggests that 12 months after initiating
ranibizumab for vision impairment from center-involved DME, patients not
driving at initiation of treatment are more likely to report driving. The
study also reported that for patients treated with ranibizumab, their visual
acuity improved to have driving-eligible visual acuity of 20/40 or better
in the better-seeing eye than those treated with sham or laser (3).
Authors also suggest that additional work needs to be done, in order to
determine whether driving skills or driving safety are maintained or improved
Meanwhile, a recent Cochrane systematic review also found high
quality evidence that antiangiogenic drugs provide a benefit for DME
patients compared to currently available other therapeutic options such as
grid laser photocoagulation (4).
1. Apte RS. What Is Chronic or Persistent Diabetic Macular Edema and How
Should It Be Treated?. JAMA Ophthalmol. Published online January 07, 2016.
2. Ford JA, Lois N, Royle P, Clar C, Shyangdan D, Waugh N. Current
treatments in diabetic macular oedema: systematic review and meta-
analysis. BMJ Open, 2013 Mar 1;3(3). pii: e002269. doi: 10.1136/bmjopen-
3. Bressler NM, Varma R, Mitchell P, et al. Effect of Ranibizumab
on the Decision to Drive and Vision Function Relevant to Driving in
Patients With Diabetic Macular Edema: Report From RESTORE, RIDE, and RISE
Trials. JAMA Ophthalmol. Published online November 19, 2015.
4. Virgili G, Parravano M, Menchini F, Evans JR. Anti-vascular
endothelial growth factor for diabetic macular oedema.Cochrane Database
Syst Rev, 2014 Oct 24;10:CD007419. doi: 10.1002/14651858.CD007419