糖尿病性黄斑水肿的治疗进展

糖尿病性黄斑水肿（DME）是糖尿病视网膜病变（DR）患者视力下降的重要原因,除有效控制血糖、血压、血脂,以及保持全身的良好健康状态外,激光光凝依然是最基本的治疗手段,新的Pascal激光器展现了比原本激光器更强大的技术优势。用于治疗DME的激素类玻璃体植入缓释系统虽展示了良好的应用前景,但还处于临床验证阶段。难治性的弥漫性黄斑水肿可考虑光凝与玻璃体注射曲安奈德、抗血管内皮生长因子类药物,甚至玻璃体手术联合治疗以提高疗效。各种新疗法以及联合疗法已经体现了较好的治疗效果,但依然没有充足的证据证明任何一种疗法或联合疗法比单一的光凝治疗要好,尚需要大规模的随机对照实验来证明其长期应用的安全性和有效性。

Treatments of diabetic macular edema

Diabetic macular edema is one of the main reasons of visual loss in diabetic retinopathy.The basic treatment is photocoagulation,besides to control the blood sugar,serum lipid and so on.The Pascal laser coagulation showed more powerful technology advantage.The intravitreal drug delivery system showed a good prospect,but still under the clinical trial.Photocoagulation could combine with IVTA,anti-VEGF or PPV in diffuse macular edema to improve efficacy.A variety of new therapies and combined therapies reflect better effects,but there is no sufficient evidence to prove any one is better than the photocoagulation for DME.Large-scale randomized controlled trails are needed to prove the long-term efficacy and safety.