糖尿病视神经病变的研究进展

Research progress of diabetic optic neuropathy

糖尿病视神经病变(diabetic optic neuropathy,DON)随糖尿病患病率增高而逐年上升,表现为糖尿病视乳头病变、视盘新生血管、非动脉炎性前部缺血性视神经病变和视神经萎缩等。荧光素眼底血管造影、相干光断层扫描血管成像、视野、视觉电生理检查等对DON具有重要诊断价值。影响DON的因素复杂,包括糖尿病病程、糖尿病视网膜病变严重程度、血糖控制情况和其他因素。DON的发生发展与糖尿病相关的代谢调节、晚期糖基化终末产物、氧化应激和血流动力学等有关,这为DON的防治提供了研究方向。视网膜光凝术、玻璃体内抗血管内皮生长因子和糖皮质激素注射治疗可有效阻止DON病情进展,达到改善患者视功能的目的。

Diabetic optic neuropathy(DON)is on the rise year by year with the increasing prevalence of diabetes and has become a significant cause of blindness and disability in the world.The manifestations of DON include diabetic papillopathy,neovascularization of optic disc,non-arteritic anterior ischemic optic neuropathy and optic nerve atrophy.Fundus fluorescein angiography,optical coherence tomography angiography,perimetry and visual electrophysiological examination have important diagnostic value for DON.The factors affecting DON are complex,including diabetes duration,severity of diabetic retinopathy,blood glucose control and so on.The occurrence and development of DON is related to diabetes-related metabolic regulation,advanced glycation end products,oxidative stress and hemodynamics,which provides a research direction for the prevention and treatment of DON.Retinal photocoagulation,intravitreal injection of anti-VEGF and glucocorticoid,can effectively prevent the progression of DON and improve the visual function of patients.