糖尿病性黄斑水肿的发病机制与治疗进展

Advances in pathogenesis and treatment of diabetic macular edema

摘要:

目前全球糖尿病视网膜病变（DR）患者约9 300万，其中增殖性DR（PDR）患者1 700万，糖尿病性黄斑水肿（DME）患者2 100万，威胁视力的DR患者2 800万。随着年龄的增长，DME现已成为糖尿病患者视力损害的主要原因。其发病机制尚未明确，研究显示视网膜内、外屏障的破坏等在DME的发生发展中起到重要作用。目前，DME的治疗方法包括传统的激光光凝、糖皮质激素的应用、抗血管内皮生长因子（VEGF）药物的玻璃体腔注射、蛋白激酶C抑制剂的应用、玻璃体手术等，但每种疗法都有其优点和不足。联合治疗重复次数少、疗效高、安全性强，是未来发展的新趋势。本文对老年性DME治疗的国内外研究现状及发展趋势进行综述。

Abstract:

There are about 93 million patients with diabetic retinopathy (DR) all over the world. Among them, 17 million are proliferative DR, 21 million have diabetic macular edema (DME), and 28 million have a threat of vision loss. With aging, DME has become a main cause of vision loss in the patients suffering from diabetes mellitus. Though its pathogenesis is not clear yet, evidence shows that break-down of the inner and outer blood-retinal barrier might be involved in the incidence and development of DME. At present, the treating methods of DME include retinal laser photocoagulation, application of glucocorticoids, intravitreous injection of anti-vascular endothelial growth factor (VEGF), administration of inhibitor of protein kinase C, vitrectomy, etc. However, each method has its advantages and disadvantages. The combined treatment has a bright future for its fewer repetitions, higher efficacy and great safety. In this paper, we reviewed current research status and future development trends of DME treatment for the elderly.