糖尿病黄斑水肿治疗方案的选择及需要关注的几个问题  

Choice of current approaches to the management of diabetic macular edema

作　　者：戴虹[1] 卢颖毅[1] 

机构地区：[1]北京医院眼科国家老年医学中心,100730

出　　处：《中华实验眼科杂志》2016年第12期1061-1064,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：北京市自然科学基金项目（7152123）;首都特色临床研究项目（Z151100004015147）

摘　　要：糖尿病黄斑水肿（DME）是引起糖尿病患者视力障碍的常见原因，DME易复发，治疗效果不尽如人意，其治疗研究的进展一直受到眼科医师的关注。目前，在国内外关于DME的治疗指南中均已将抗血管内皮生长因子（VEGF）疗法作为一线的或核心的治疗方法，该疗法在临床上已广泛使用。但在临床实践中我们发现，DME治疗方法的选择和实施仍有不明确之处，同时也存在一定的争议，包括DME的治疗目标、疗效的判断指标、对国内外指南的解读、抗VEGF疗法的实施方案、传统激光光凝的作用和临床价值、糖皮质激素类药物的应用方法、复发性DME的处理原则等。近年来针对DME治疗的药物研究仍在进行并取得了一定进展，只有跟踪相关的研究成果，不断完善DME的治疗方法，充分了解不同药物和不同治疗方案的优势和缺点，规范治疗流程，才能最大程度地发挥各种治疗方法或联合疗法对DME的治疗作用。Diabetic macular edema （DME） is the most common reason for visual impairment in diabetic eye diseases. DME is easy to relapse and the treatment outcome is beyond satisfied. Anti-vascular endothelial growth factor （anti-VEGF） therapy has been proposed to be a first-line or key treatment regimen in the management guideline for DME. However, in clinical practice, there still are many ambiguous and controversial views in the choice and implement of different managing paradigms, including the therapeutical goal, the assessment of treatment effectiveness, the explanation of the guidelines, the regimen of anti-VEGF therapy, the value evaluation of laser photocoagulation, the use of steroids and the management of recurrent DME. Recently, the researches of treating drugs for DME are developing and/naking a great progress, so eye doctors should track the research results, improve the therapeutical regimen, fully understand the advantages and disadvantages of different treating methods and standardize the treatment process in order to release the best treatment effects on DME.

关 键 词：糖尿病/并发症 黄斑水肿/治疗效果 指南 血管内皮生长因子 激光/治疗用途 治疗方案 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]