Efficacy and Clinical Predictors of Topical NSAIDs as Bridging Therapy for Diabetic Macular Edema: A Systematic Review and Meta-Analysis

A pooled Odds Ratio–derived 28-point scoring system for diabetic macular edema links HbA1c (6/12; OR 1.96) and NPDR stage (OR 1.77) to topical NSAID response.

• Why it matters: Referral delays in primary care can allow diabetic macular edema to progress and damage photoreceptors, creating a need for interim treatment guidance.
• What they did: A systematic review and meta-analysis of 12 studies pooled Odds Ratios for clinical predictors of response to topical NSAIDs, then converted ln(OR) values into a point-based score.
• The result: Potent topical NSAIDs are reported to stabilize macular thickness and prevent exudative progression during the referral window, and the score stratifies patients into high (21–28), moderate (12–20), and low (0–11) probability tiers.

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