糖尿病性黄斑水肿的临床研究进展

Clinical research progress in diabetic macular edema

糖尿病黄斑水肿（diabetic macular edema，DME）是指南于糖尿病引起的黄斑中心1D以内的视网膜增厚或硬性渗出。是造成糖尿病性视网膜病变（diabetic retinopathy，DR）视力下降的主要原因之一。其发病机制推测是视网膜内、外屏障的破坏以及细胞因子的作用。有多种检查可以对黄斑水肿做出诊断，包括眼底血管荧光造影（FFA）、视网膜断层摄影仪（HRT）、光学相干断层扫描（OCT）等。激光治疗仍然是目前最广泛使用的治疗方法，临床上一直探索其更有效的治疗方法，玻璃体腔注射糖皮质激素等药物的应用，以及玻璃体切除联合视网膜内界膜剥离术等治疗措施联合应用，目前取得了较好的效果，在治疗糖尿病黄斑水肿方面尽管已有巨大进展，但显然尚需有效、副作用更小的治疗措施。

Diabetic macular edema （DME） is caused by diabetes, featured by retinal thickening or hard exudates at macular center within 1D. It is one of the main reasons for decreased vision of diabetic retinopathy （DR）. Its pathogenesis is speculated to be the damage of retinal inteernal and external barrier, as well as the role of cytokines. There are many checks that can make the diagnosis of macular edema, including fundus fluorescein angiography （ FFA ）, heidelberg retina tomography （ HRT）, optical coherence tomography （OCT） and so on. Laser treatment is still the most widely used method of treatment. DEM＇s more effective treatment methods have always been being clinically explored. Applications such as intravitreal injection of corticosteroid drugs, as well as co-vitrectomy retinal internal limiting membrane peeling surgery and other treatments in combination, have now achieved a good result. Despite that the treatment of DME is in great progress, it apparently still needs more effective treatment measures of less side effects.