地塞米松玻璃体内植入剂治疗糖尿病性黄斑水肿的研究进展  

Research progress of Dexamethasone intravitreal implants in the treatment of diabetic macular edema

作　　者：袁小婷 黄娇[1,2] 程晓娟 李蓉 许立帅 Yuan Xiaoting;Huang Jiao;Cheng Xiaojuan;Li Rong;Xu Lishuai(Medical School of Ophthalmology&Optometry,North Sichuan Medical College,Nanchong 637000,Sichuan Province,China;Department of Ophthalmology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China)

机构地区：[1]川北医学院眼视光医学院,四川省南充市637000 [2]川北医学院附属医院眼科,四川省南充市637000

出　　处：《国际眼科杂志》2025年第1期82-87,共6页International Eye Science

基　　金：南充市市校战略科技合作专项(No.22SXQT0168);川北医学院博士启动基金(No.CBY21-QD28,CBY24-QDA01)。

摘　　要：糖尿病性黄斑水肿(DME)作为糖尿病视网膜病变(DR)的严重并发症是一种多因素引起的慢性疾病,炎症因子和血管内皮生长因子(VEGF)在其发展过程中贯穿始终。抗VEGF药物在治疗DME中取得了显著效果,但存在部分患者应答不佳或需要频繁给药等缺点。地塞米松玻璃体内植入剂(DEX植入剂)作为缓释型植入剂有着良好的释放曲线和高效的生物利用度,具有安全、有效且持续的抗炎作用,帮助修复视网膜屏障并减少渗出。为进一步提高患者的视觉质量,探索DEX植入剂与现有治疗方案联合治疗的疗效具有重要临床意义。文章就DEX植入剂的药理特性、适用条件、以及与现有药物和治疗手段联合应用的研究进展进行简要阐述,评估联合或换药治疗相对于现行标准治疗的优劣,以期为DME的个性化治疗选择提供参考。Diabetic macular edema(DME),a serious complication of diabetic retinopathy(DR),is a chronic condition caused by multiple factors.Throughout its progression,inflammatory factors and vascular endothelial growth factor(VEGF) play a critical role.Anti-VEGF drugs have shown significant effectiveness in the treatment of DME;however,some patients may experience persistent DME after injection or require frequent injections.Dexamethasone intravitreal implants(DEX implants) serve as a sustained-release implant characterized by a reasonable release profile and high bioavailability.They offer safe,effective,and prolonged anti-inflammatory effects,aiding in the repair of retinal barrier and reduction of exudation.To further enhance patients' visual quality,exploring the efficacy of DEX implants in combination with existing treatment regimens has great clinical significance.This review primarily discusses the research advancements in DEX implants,focusing on their pharmacological properties,indications for use,and their combination with existing drugs and treatment methods.It also evaluates the advantages and disadvantages of combination therapy or switching to DEX implants compared to current standard treatments,aiming to provide guidance for personalized treatment options for patients with DME.

关 键 词：地塞米松玻璃体内植入剂 糖尿病性黄斑水肿 炎症 联合治疗 

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