Suprachoroidal injection in the treatment of diabetic macular edema: mechanisms, clinical advances, and future perspectives

Diabetic macular edema (DME) is the leading cause of vision loss in patients with diabetes. Conventional therapies like intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) agents and corticosteroids are often limited by the frequent injections and risks of complications. Suprachoroidal space (SCS) injection has emerged as a novel drug delivery technique. It targets eye precisely, resulting in high drug concentration in the posterior segment while reducing exposure to anterior segment tissues-thereby potentially lowering risks of both cataract formation and elevated intraocular pressure. Clinical data shows that SCS injection of triamcinolone acetonide (TA) can significantly improve vision, reduce both macular edema and treatment frequency in DME patients. In this review, we mainly aim to introduce the advantages and clinical evidence of SCS injection, and emphasize its potential role in optimizing DME management strategy.