摘要
糖尿病视网膜病变(DR)是工作年龄人群主要的且不可逆的致盲性眼病。而糖尿病黄斑水肿(DME)是DR进一步发展的并发症,是引起DR患者视力下降的主要原因之一。抗VEGF药物的出现,改写了DR和DME的治疗模式。首先,对于DME的治疗,由之前的局灶/格栅样激光光凝,转换成抗VEGF药物为一线治疗。其次,对于增生型DR(PDR)的治疗,既往全视网膜激光光凝是金标准,现在抗VEGF药物成了部分PDR患者治疗的替代方案。临床上,面对不同程度的DR及DME,何时开始治疗、何种治疗优先、抗VEGF药物治疗是否能完全取代激光以及抗VEGF药物治疗时代关于DR的治疗模式等问题均值得临床医师进一步思考。深入学习激光和抗VEGF药物治疗DR的临床研究,关注临床指南和专家共识的变迁,逐步建立适合我国国情的DR及DME的治疗思路,实现DR患者的个性化治疗,有利于提高我国DR的治疗水平。
Diabetic retinopathy(DR)is a major and irreversible blinding eye disease in working aged adults.Diabetic macular edema(DME)is a complication of the further development of DR,and it is one of the main causes of vision loss in DR patients.The emergence of anti-VEGF drugs has changed the treatment model of DR and DME.Firstly,for the treatment of DME,the previous focal/grid-like laser photocoagulation is converted to anti-VEGF drugs as the first-line treatment.Secondly,for the treatment of proliferative DR(PDR),panretinal photocoagulation(PRP)was the gold standard in the past,and now anti-VEGF drugs have become an alternative treatment for some PDR patients.In varying degrees of DR and DME,the option of treatment,anti-VEGF drug therapy replacing PRP,and the era of anti-VEGF drug therapy on DR treatment modes are worthy questions for consideration by clinicians.In-depth study of the clinical study of PRP and anti-VEGF drugs in the treatment of DR,the changes attention in clinical guidelines and expert consensus,the gradual establishment of treatment of DR and DME suitable,and the personalized treatment of DR patients may help improve the level of DR treatment in China.
作者
刘晓玲
孙祖华
Liu Xiaoling;Sun Zuhua(Eye Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2020年第10期749-753,共5页
Chinese Journal of Ocular Fundus Diseases
基金
国家科技重大专项(2017YFA0105300)。
