Chowdhury T A, Hopkins D, Dodson P M, Vafidis G C
Department of Medicine, Central Middlesex Hospital, London, UK.
Eye (Lond). 2002 Nov;16(6):689-93. doi: 10.1038/sj.eye.6700205.
Diabetic maculopathy is a common complication of diabetes mellitus, characterised by macular oedema and frequently accompanied by lipid exudation. It is the major cause of loss of vision from diabetic retinopathy. There is some evidence to implicate serum lipids in exudative maculopathy; cross-sectional studies suggest that higher serum lipid levels are found in patients with macular exudates, and prospective studies have shown an increased risk of exudative maculopathy if baseline cholesterol is higher. The treatment for diabetic maculopathy is laser photocoagulation of the pigment epithelium. With the advent of systemic lipid lowering therapy over the last decade, there may be potential for medical therapy also. There is some anecdotal evidence of the effect of lipid lowering agents (particularly statins) in reducing exudate, and a number of studies have shown that lipid lowering therapy may reduce macular exudates, but numbers in these trials are small. A randomised controlled trial is now required to investigate whether the use of systemic lipid lowering therapy is of benefit in patients with exudative maculopathy, even in the absence of dyslipidaemia.
糖尿病性黄斑病变是糖尿病的常见并发症，其特征为黄斑水肿，常伴有脂质渗出。它是糖尿病性视网膜病变导致视力丧失的主要原因。有证据表明血清脂质与渗出性黄斑病变有关；横断面研究表明，黄斑渗出患者的血清脂质水平较高，前瞻性研究显示，如果基线胆固醇水平较高，渗出性黄斑病变的风险会增加。糖尿病性黄斑病变的治疗方法是对色素上皮进行激光光凝。随着过去十年全身降脂治疗的出现，药物治疗也可能具有潜力。有一些轶事证据表明降脂药物（特别是他汀类药物）在减少渗出方面的作用，并且一些研究表明降脂治疗可能会减少黄斑渗出，但这些试验中的样本量较小。现在需要进行一项随机对照试验，以研究即使在没有血脂异常的情况下，全身降脂治疗对渗出性黄斑病变患者是否有益。
