Phenotype-driven management of diabetic macular edema: multimodal imaging biomarkers and individualized therapy - Summary - MDSpire

Phenotype-driven management of diabetic macular edema: multimodal imaging biomarkers and individualized therapy

  • By

  • Zichao You

  • Li Jiang

  • Ying-rui Liu

  • Ming Ming Yang

  • June 23, 2026

  • 0 min

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Objective:

To compile current evidence regarding key imaging biomarkers pertinent to the individualized management of diabetic macular edema (DME) and explore their incorporation into an imaging phenotype-based methodology for treatment selection.

Approach:
    Key Findings:
    • Markers of disease activity include intraretinal and subretinal fluid along with hyperreflective foci.
    • Predictors of visual prognosis consist of disorganization of the retinal inner layers, photoreceptor injury, and retinal perfusion deficits.
    • DME can be classified into five clinical phenotypes: leakage-dominant, inflammatory, tractional, focal-treatment, and poor-prognosis phenotypes.
    Interpretation:

    The integration of imaging biomarkers into a proposed, hypothesis-generating decision-support framework aims to align therapeutic approaches with underlying pathogenic mechanisms in DME.

    Limitations:
    • Variability in imaging acquisition protocols and biomarker specifications across studies.
    • Limited high-level evidence for some emerging biomarkers.
    Conclusion:

    Future advancements in automated biomarker quantification and AI-assisted image analysis may enhance precision in DME phenotyping and facilitate individualized disease management.

Original Source(s)

Phenotype-driven management of diabetic macular edema: multimodal imaging biomarkers and individualized therapy

  • by Zichao You, Li Jiang, Ying-rui Liu, Ming Ming Yang

  • June 23, 2026

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