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Clinical Research | Open Access

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Nor Fariza Ngah1,2Nor Asiah Muhamad3( )Shelina Oli Mohamed2Roslin Azni Abdul Aziz2Nur Hasnah Ma’amor3Nor Azita Ahmad Tarmidzi4Hanizasurana Hashim5Hamisah Ishak4Wan Norliza Wan Muda6Rosiah Muda7Azian Adnan8Rafidah Md Saleh9Hon Seng Wong10Nurfahzura Mohd Jamil11Tara Mary George12Adrian Koh13
Institute for Clinical Research, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
Department of Ophthalmology, Shah Alam Hospital, Ministry of Health, Selangor 40000, Malaysia
Sector for Evidence-based Healthcare, National Institutes of Health, Ministry of Health, Selangor 40170, Malaysia
Department of Ophthalmology, Kuala Lumpur Hospital, Ministry of Health, Federal Territory 50586, Malaysia
Department of Ophthalmology, Selayang Hospital, Ministry of Health, Selangor 61800, Malaysia
Department of Ophthalmology, Tengku Ampuan Afzan Hospital, Ministry of Health, Pahang 25100, Malaysia
Department of Ophthalmology, Sultanah Nur Zahirah Hospital, Ministry of Health, Kuala Terengganu 20400, Malaysia
KPJ Selangor Specialist Hospital, Selangor 40300, Malaysia
Sultan Abdul Aziz Shah Hospital, Selangor 43400, Malaysia
Gleneagles Kuala Lumpur, Federal Territory 50450, Malaysia
Department of Ophthalmology, Sungai Buloh Hospital, Ministry of Health, Selangor 47000, Malaysia
Sunway Medical Centre, Selangor 47500, Malaysia
Camden Medical Centre, Singapore 248649, Singapore

Co-first authors: Nor Fariza Ngah and Nor Asiah Muhamad

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Abstract

AIM

To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group’s efforts for diagnosis, treatment, and best practices of diabetic macular edema (DME). The experts’ panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula. The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.

METHODS

On two different occasions, a panel of 14 retinal specialists from Malaysia, together with an external expert, responded to a questionnaire on management of DME. A consensus was sought by voting after compiling, analyzing and discussion on first-phase replies on the round table discussion. A recommendation was deemed to have attained consensus when 12 out of the 14 panellists (85%) agreed with it.

RESULTS

The terms target response, adequate response, nonresponse, and inadequate response were developed when the DME patients’ treatment responses were first characterized. The panelists reached agreement on a number of DME treatment-related issues, including the need to classify patients prior to treatment, first-line treatment options, the right time to switch between treatment modalities, and side effects associated with steroids. From this agreement, recommendations were derived and a treatment algorithm was created.

CONCLUSION

A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.

References

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International Journal of Ophthalmology
Pages 712-720

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Cite this article:
Ngah NF, Muhamad NA, Mohamed SO, et al. Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population. International Journal of Ophthalmology, 2023, 16(5): 712-720. https://doi.org/10.18240/ijo.2023.05.07

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Received: 12 October 2022
Accepted: 23 March 2023
Published: 18 May 2023
© 2023 International Journal of Ophthalmology Press

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).