摘要
糖尿病视网膜病变(diabetic retinopathy,DR)是目前成年人主要致盲原因之一,而全视网膜光凝(panretinal photocoagulation,PRP)是治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的标准方法。在深入研究玻璃体注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物治疗糖尿病黄斑水肿的同时,抗VEGF治疗可导致DR严重程度回退的现象受到广泛关注。近期研究结果表明,抗VEGF治疗PDR具有非劣于PRP的临床效果。然而,抗VEGF治疗长期应用带来的巨大经济负担使得这一方法并不能适合所有患者。PRP仍然在DR临床管理中发挥重要作用,抗VEGF联合PRP也可为PDR治疗带来益处,但联合治疗的方案尚有争议。未来可延长抗VEGF治疗时间间隔的新型药物和新型给药装置可望拓宽抗VEGF治疗的应用。
Diabetic retinopathy(DR)is the leading cause of blindness among working-age adults in the world.Panretinal photocoagulation(PRP)is the standard treatment for proliferative diabetic retinopathy(PDR).Intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF)agent in diabetic macular edema has been studied deeply,while it has also been noted that anti-VEGF treatment can induce regression of DR.Recent studies show that anti-VEGF treatment is noninferior to PRP for PDR,however it may not be viable for all patients because of its cost burden in long-term DR management.PRP still plays an important role in management of DR,and patients may get benefits from combination therapy with PRP and anti-VEGF treatment.The algorithm of the combination therapy needs still to be discussed.The development of new agents and new drug delivery systems which can prolong the durability of anti-VEGF treatment may help us to broaden the implementation of anti-VEGF treatment.
作者
李毅斌
LI Yi-bin(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing Tongren Hospital,Capital Medical University, Beijing 100005,China)
出处
《眼科》
CAS
2019年第4期245-248,共4页
Ophthalmology in China
