合理使用抗VEGF药物辅助治疗糖尿病视网膜病变

The rational use of anti-vascular endothelial growth factor drugs to assist the treatment of diabetic retinopathy

糖尿病性视网膜病变(DR)是糖尿病致盲最重要的病因,血管内皮生长因子(VEGF)被认为是介导DR病理生理改变的重要因素,由此衍生出的抗VEGF疗法在DR治疗领域迅速发展,但同时临床应用也出现一些误区,对其应用策略不清晰,甚至夸大了其治疗作用。本文通过探讨抗VEGF疗法能否逆转DR的病程、能否促进DR玻璃体积血吸收、能否取代眼底激光治疗,提出抗VEGF疗法在DR治疗中的应用策略,指出现阶段在抗VEGF疗法不能完全取代眼底激光治疗的前提下,尚不应夸大其临床应用价值。在未来,期待有更多创新药物和疗法为治疗DR并同时保护视功能提供新的途径。

Diabetic retinopathy (DR) is one of the most important etiologies of diabetic blindness. The vascular endothelial growth factor (VEGF) is thought to mediate pathophysiological changes of DR. Anti-VEGF therapy for DRdevelops rapidly. However, there are some misunderstandings about its clinical application, and the strategy is not clear. Sometimes its therapeutic effects are even exaggerated. In this article, by discussing whether anti-VEGF therapy can reverse the course of DR disease, promote the absorption of vitreous hemorrhage, and replace fundus laser therapy, the application strategy of anti-VEGF therapy for DR is proposed. At present, anti-VEGF therapy cannot completely replace retinal photocoagulation therapy, and its clinical application value should not be exaggerated. More innovative drugs and therapies are expected to provide new ways forthe treatment of DR while preserving visual function.