抗血管内皮生长因子药物治疗糖尿病视网膜病变的研究现状

糖尿病可引起眼内血管内皮生长因子（vascularendothelialgrowthfactor，VEGF）水平病理性升高，导致眼内新生血管形成、黄斑水肿的发生。抗VEGF药物最早被用于湿性年龄相关性黄斑变性，现也被试验性地用于糖尿病视网膜病变（diabeticretinopathy，DR）。VEGFl65选择性拮抗剂Pe—gaptanib与VEGF—A单抗Ranibizumab被批准玻璃体内注射，且对DR有较好的疗效；VEGF．A全长抗体Bevacizumab被标示外用于玻璃体内注射治疗DR，也能达到较好的效果；重组融合蛋白Aflibercept针对DR的疗效也得到一些试验的支持。玻璃体内注射抗VEGF药物治疗DR已被证实短期有效且安全，但其长期的疗效与安全性有待更多的大规模临床试验来验证。

Clinical research progress of anti-VEGF agents for diabetic retinopathy

Diabetes mellitus can pathologically elevate ocular vascular endothelial growth factor （VEGE） level, which causes the angiogenesis and edema in eyes. The extensive use of anti-VEGF agents for the age-related macular degeneration （AMD） has prompted research into the application of anti-VEGF drugs for the diabetic retinopathy （DR）. Pegaptanib and ranibizumab, which are approved for intravitreal injection, have shown short-term effect on visual acuity improvement. And off-label intravitreal use of bevacizumab has shown short-term positive effects on both visual acuity improvement and central retinal thickness. Affibercept has also been regarded as an effective treatment to DR, which is supported by trials. The growing evidence indicates that anti-VEGF agents are beneficial for the DR treatment, especially the one with diabetic macular edema （DME）. Still, physicians expect the results of large, controlled trials to substantiate the long-term efficacy and safety of anti-VEGF drugs for DR.