抗VEGF时代激光光凝治疗糖尿病视网膜病变的再认识

Reconsideration on laser photocoagulation for diabetic retinopathy in the anti-VEGF era

增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)是糖尿病致盲的主要原因。全视网膜光凝(panretinal photocoagulation,PRP)是目前治疗PDR的标准方法,但是存在加重黄斑水肿、导致周边视野缺失等不良反应。玻璃体注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物可有效抑制视网膜和视盘新生血管,改善糖尿病视网膜病变的严重程度,展示了替代PRP治疗糖尿病视网膜病变的良好前景。正确认识抗VEGF药物的临床价值,探索PRP联合抗VEGF疗法的模式和方法有助于改善PDR的治疗预后。

Proliferative diabetic retinopathy （PDR） is the leading cause of diabetic blindness. At present, panretinal photocoagula- tion （PRP） is the standard treatment for PDR, however it can cause side effects, such as increasing risk of macular edema, or decreasing peripheral vision. Anti-vascular endothelial growth factor （VEGF） therapy shows the possibility of treatment as a substitution for PRP： intrvitreal anti-VEGF agent can effectively clear intraocular VEGF, cause regression of new vessels, and improve retinopathy severity. It may improve the prognosis of PDR to explore the module and methods of combination of PRP and anti-VEGF therapy.