摘要
糖尿病性黄斑水肿(DME)是糖尿病患者中心视力损害的主要原因之一。在抗血管内皮生长因子药物问世前,激光光凝术曾是DME的主要治疗方式。传统激光减轻黄斑水肿效果显著,但对视网膜正常结构造成潜在损伤,已不再作为DME的首选疗法。近年来随着对激光参数和作用模式的改良,出现阈值下微脉冲、选择性视网膜疗法等新型激光,可选择性作用于视网膜色素上皮细胞,对神经上皮组织损伤小,展现出良好的安全性和有效性。微脉冲激光作为抗血管内皮生长因子的辅助治疗,可在达到相近治疗效果的同时减少注射药物的次数。同时,对于抗血管内皮生长因子治疗应答不佳的患者,微脉冲激光也展现出一定优势。本文将对激光光凝术在DME中的应用进展进行综述。
Diabetic macular edema(DME)is one of the primary causes of central visual impairment in diabetic patients.Before the advent of anti-vascular endothelial growth factor(anti-VEGF)therapies,laser photocoagulation was the primary intervention for DME.The clinical application of conventional laser photocoagulation in DME has been relegated from its erstwhile status as a first-line treatment option due to its potential damage to retinal structures.In recent years,however,with the modifications in laser parameters and operational modalities,novel laser technologies,such as subthreshold micropulse laser photocoagulation and selective retinal therapy,have emerged as promising treatment alternatives for DME.The modified lasers selectively target retinal pigment epithelium and cause minimal damage to the neuroepithelial tissue,enabling a high safety profile.As an adjunctive therapy to intravitreal anti-VEGF injections,micropulse laser therapy offers a dual benefit by maintaining treatment efficacy while reducing the frequency of injections,thereby alleviating the treatment burden on patients.Moreover,for individuals exhibiting suboptimal responses to anti-VEGF therapy,micropulse laser treatment has demonstrated potential advantages.This article aims to provide a comprehensive overview of the application and recent advancements of macular laser therapy in the management of DME.
作者
谢碧瑶
黄梓敬
Xie Biyao;Huang Zijing(Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong,Shantou 515041,Gruangdong Province,China;不详)
出处
《临床眼科杂志》
2024年第6期568-575,共8页
Journal of Clinical Ophthalmology
基金
国家自然科学基金(82101112)
汕头市医疗卫生科技计划项目[汕府科(2022)169号-101]。
