Objective:

To identify unmet needs in the management of diabetic macular edema (DME) through expert consensus, emphasizing the role of expert insights in shaping understanding.

Key Findings:

• Approximately 60% of patients remain untreated one year after DME diagnosis, highlighting a critical gap in care.
• There is a lack of early treatment options for mild or early-stage DME, which may lead to worsening outcomes.
• Panelists favored noninvasive treatments over intravitreal therapy, especially at early visual acuity loss thresholds, indicating a preference for less invasive approaches.
• Consensus was reached on definitions for treatment response and the importance of intraretinal fluid in monitoring DME, which could guide future treatment strategies.

Interpretation:

The findings indicate significant gaps in DME management, particularly in early intervention and the availability of noninvasive treatment options, highlighting a mismatch between available therapies and clinical decision-making.

Limitations:

• Existing therapies, including anti-VEGF agents, have inadequate response rates in a substantial proportion of patients, which may affect treatment outcomes.
• The study may not encompass all perspectives on DME management due to its expert panel design, potentially limiting the applicability of the findings.

Conclusion:

The DME AWARE Study underscores the need for improved early intervention strategies and noninvasive treatment options in DME management.