What CMT warrants anti-VEGF treatment for DME?

Center-involving DME with CMT >300-320 μm on OCT associated with vision-threatening macular thickening; CMT >400 μm is severe; anti-VEGF (ranibizumab, aflibercept, bevacizumab) first-line if BCVA <6/9 or CMT above threshold.

What is the treat-and-extend protocol for DME?

Monthly anti-VEGF until CMT <300 and BCVA stable; then extend interval by 2 weeks each visit; maximum extension typically 12-16 weeks; if activity recurs (CMT increase, BCVA loss), shorten interval by 2 weeks.

When is focal laser used for DME?

Focal/grid laser for non-center-involving DME; subthreshold micropulse laser emerging as alternative; laser is now second-line to anti-VEGF for vision-threatening center-involving DME based on DRCR Network Protocol I results.

What OCT biomarkers predict poor anti-VEGF response in DME?

Chronic DME with disorganization of retinal inner layers (DRIL), ellipsoid zone disruption, and subretinal fluid persistence despite treatment predict poor visual recovery; early treatment and tight metabolic control improve outcomes.

What adjunct steroid therapies are used in refractory DME?

Dexamethasone implant (Ozurdex) 700 μg every 4-6 months for anti-VEGF refractory or pseudophakic DME; fluocinolone acetonide implant (Iluvien) for 3 years; steroid response (IOP rise >10 mmHg) limits use in phakic patients.

Diabetic Macular Oedema Central Macular Thickness Threshold

Calculates treatment threshold for diabetic macular oedema using central macular thickness (CMT >300-320 μm), BCVA, and anti-VEGF injection interval optimization using treat-and-extend protocol.

Use the full interactive calculator below, or

Related Calculators

DR Severity Grade

Medical Calculators

AMD AREDS2 Score