Can suprachoroidal injections help improve vision in diabetic macular edema?
Diabetic macular edema (DME) is a leading cause of vision loss in people with diabetes. Standard treatments include anti-VEGF injections or corticosteroids placed into the vitreous (intravitreal). Suprachoroidal injection is a newer method that delivers medication into a space between the sclera and choroid, aiming to target the back of the eye more precisely while reducing side effects like cataracts and high eye pressure. Early evidence suggests this approach can improve vision and reduce macular edema in DME, but it is not yet a routine treatment.
What the research says
A narrative review highlights that suprachoroidal injection of triamcinolone acetonide (a corticosteroid) can significantly improve vision and reduce macular edema in DME patients, while potentially lowering risks of cataract and elevated intraocular pressure compared to standard injections 1. A 2024 case series combining suprachoroidal triamcinolone with intravitreal Ziv-aflibercept (an anti-VEGF) in 10 eyes showed vision improved from 20/100 to 20/50 and central macular thickness decreased by about 100 microns over 24 weeks 10. Another case series in 11 eyes that had prior vitrectomy surgery found similar benefits: vision improved and swelling reduced significantly at 8 weeks, with no rise in eye pressure or cataract progression 11. However, these are small, short-term studies. The FDA has approved a suprachoroidal triamcinolone product (Xipere) for uveitis-related macular edema, and research is ongoing for DME 9. Larger, longer trials are needed to confirm safety and effectiveness compared to standard treatments.
What to ask your doctor
- Is suprachoroidal injection an option for my diabetic macular edema, or should I stick with standard intravitreal injections?
- What are the potential benefits and risks of suprachoroidal versus intravitreal corticosteroids for my eye condition?
- Are there any ongoing clinical trials for suprachoroidal injections in DME that I might be eligible for?
- How does the cost and frequency of suprachoroidal injections compare with my current treatment plan?
- If I have had eye surgery before, would suprachoroidal injection still be safe and effective for me?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.