Abstract
Diabetic macular edema (DME) is a leading cause of visual impairment among individuals with diabetes mellitus, representing a major global public health concern. Technological advancements and novel therapeutic strategies have redefined the landscape of diagnosis and management. This systematic review aims to consolidate recent literature (2020–2025) regarding innovations in diagnostic imaging, pharmacologic agents, and clinical strategies for the effective management of DME. A systematic search of PubMed, Scopus, and Web of Science databases was conducted to identify peer-reviewed articles published between January 2020 and July 2025. The review included randomized controlled trials (RCTs), meta-analyses, cohort studies, and high-quality systematic reviews. The selection criteria focused on studies that evaluated recent diagnostic modalities and emerging therapeutic approaches for DME. Data extraction and quality appraisal followed PRISMA guidelines. Recent advances in diagnosis include the integration of artificial intelligence (AI)-enhanced retinal imaging, such as optical coherence tomography angiography (OCTA), and machine-learning prediction models for disease progression. Innovations in management include the introduction of bispecific antibodies like faricimab, systemic agents such as oral lamivudine, and potential future directions like gene therapy and IL-6 inhibitors. These treatments offer improved durability, reduced treatment burden, and expanded personalization. Teleophthalmology and AI-driven decision support systems also show promise in enhancing accessibility and precision of care. The management of DME is shifting from a one-size-fits-all approach to a more individualized, technology-enabled paradigm. Recent advances in imaging and therapeutics offer substantial improvements in efficacy, durability, and patient adherence. Continued research into biomarker-driven interventions and AI-guided algorithms is expected to further optimize care delivery.