糖尿病性视网膜病变的治疗进展

Progress in the treatment of diabetic retinopathy

激光光凝、药物治疗、玻璃体切割术(PPV)是目前治疗糖尿病性视网膜病变(DR)的主要方法。传统激光光凝治疗具有相对安全、疗效作用持久等优势,但激光可损害患者视觉质量;PPV虽能挽救部分患者的视力,但手术风险及创伤较大;药物治疗可在DR早期应用,但糖皮质激素类药物具有明确的副作用,故不能作为主要治疗方法;抗血管内皮生长因子(VEGF)药物治疗能从发病机制上有效抑制DR的发生发展,但疗效相对较短,反复治疗的安全性和有效性目前仍需进一步大样本研究。本文旨在对DR的临床治疗进展进行综述,以期为制定有效的临床治疗方案提供参考。

Currently,the main methods for treating diabetic retinopathy(DR):laser photocoagulation,medication,pars plana vitrectomy(PPV).The advantages of traditional laser photocoagulation are:relatively safe,long-lasting effect,but laser damages the visual quality of patients;PPV can save the vision of some patients,the risk and trauma of the surgery are greater.Although pharmacotherapy is applicable in the early stages of DR,glucocorticoids cannot be used as the main treatment because of their definite side effects;anti-vascular endothelial growth factor(VEGF)drug therapy can block diabetes from the pathogenesis.The occurrence and development of sexual retinopathy,however,the efficacy is relatively short,and the potential dangers and systemic side effects of repeated treatment still require further large-scale studies.