糖尿病视网膜病变治疗研究现状、问题与展望

The status, problem and progress of diabetic retinopathy treatment

糖尿病视网膜病变（DR）的眼科治疗干预手段主要包括激光光凝、玻璃体腔注射抗血管内皮生长因子（VEGF）药物或糖皮质激素以及玻璃体切割手术治疗，可以延缓DR进展，防止严重的视功能丧失。但这些治疗干预手段多未针对导致DR发生发展的病理机制和影响因素，不能完全阻止部分患者病情进展导致的致盲性损害。随着相关学科专业研究的不断深入以及对DR发生发展影响因素的全面了解，针对DR发生发展影响因素的分子通路、神经保护、微血管损伤修复与保护等病理机制层面的干预以及基因治疗、非VEGF依赖性的抗新生血管药物等新的治疗干预手段探索方兴未艾，展现出良好应用前景。基于新的治疗靶点的个性化精准治疗是DR治疗干预研究的发展方向。

Laser photocoagulation, intravitreal injection of antibody against vascular endothelial growth factor （VEGF） or corticosteroids and pars plana vitrectomy are current popular therapeutic approaches for diabetic retinopathy （DR）. However, some DR patients still progress to irreversible blindness even after the above treatments which do not aim at the pathological mechanisms and influence factors for DR. Thus, with the further elucidation on the molecular pathological mechanisms and overall understanding of the factors affecting DR development, more and more potential therapeutic interventions such as neuron protection, vascular reconstruction and protection, gene therapy, non-VEGF dependent anti- neovascularization agents have been explored. Individual precise therapy based on the potential therapeutic targets would provide the promising future for DR patients.