糖尿病性黄斑水肿治疗方法的选择

Choice of treatment for diabetic macular edema

糖尿病性黄斑水肿（DME）是糖尿病的主要致盲原因,是因血-视网膜屏障被破坏引发血管通透性增加所导致,包括血管内皮生长因子（VEGF）在内的一系列细胞因子参与了DME的形成.传统治疗主要依赖视网膜激光光凝.近年来抗VEGF治疗逐步成为DME的一线治疗方式,但有很多DME患者抗VEGF治疗无效,尤其难治性DME患者.糖皮质激素治疗有效,充分证明了炎性机制在DME发病中的作用.在此,我们将重点讨论和比较DME抗VEGF治疗和抗炎治疗的现状和效果,以期为临床工作提供参考.

Diabetic macular edema （DME）,which is the consequence of the failed blood-retinal barrier,has become a leading cause of blindness in diabetic patients.Vascular endothelial growth factors （VEGF） and a series of inflammatory factors participate in the pathophysiology of DME.Laser photocoagulation was accepted as the first-line therapy before anti-VEGF therapy was proved to be more effective by several clinical trials.Anti-VEGF therapy has been regarded as the standard treatment,but there are still lots of cases resistant to anti-VEGF therapy.Corticosteroid treatment has also been proved effective,especially in refractory DME.This demonstrates that inflammation plays a role in DME as well.Here we discuss the situation of anti-VEGF and anti-inflammation therapies for DME.