The Role of Intravitreal Corticosteroids in the Treatment of DME: Predictive OCT Biomarkers

Munk, Marion R; Somfai, Gabor Mark; de Smet, Marc D.; Donati, Guy; Menke, Marcel N.; Garweg, Justus; Ceklic, Lala (2022). The Role of Intravitreal Corticosteroids in the Treatment of DME: Predictive OCT Biomarkers. International journal of molecular sciences, 23(14), p. 7585. MDPI 10.3390/ijms23147585

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Abstract: This work aims to summarize predictive biomarkers to guide treatment choice in DME.
Intravitreal anti-VEGF is considered the gold standard treatment for centers involving DME, while
intravitreal steroid treatment has been established as a second-line treatment in DME. However, more
than 1/3 of the patients do not adequately respond to anti-VEGF treatment despite up to 4-weekly
injections. Not surprisingly, insufficient response to anti-VEGF therapy has been linked to low-normal
VEGF levels in the serum and aqueous humor. These patients may well benefit from an early switch to
intravitreal steroid treatment. In these patients, morphological biomarkers visible in OCT may predict
treatment response and guide treatment decisions. Namely, the presence of a large amount of retinal
and choroidal hyperreflective foci, disruption of the outer retinal layers and other signs of chronicity
such as intraretinal cysts extending into the outer retina and a lower choroidal vascular index are all
signs suggestive of a favorable treatment response of steroids compared to anti-VEGF. This paper
summarizes predictive biomarkers in DME in order to assist individual treatment decisions in DME.
These markers will help to identify DME patients who may benefit from primary dexamethasone
treatment or an early switch

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Munk, Marion, Garweg, Justus


600 Technology > 610 Medicine & health








Marion Munk

Date Deposited:

12 Jul 2022 15:20

Last Modified:

05 Dec 2022 16:21

Publisher DOI:





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