Shah Chirag A
Department of Life Sciences, Accelaire Consulting and Research Pvt. Ltd., Pune-411 037, India.
Indian J Med Sci. 2008 Dec;62(12):500-19.
Diabetic retinopathy (DR) remains one of the leading risk factors and causes of blindness worldwide. Tight metabolic and blood pressure control has been shown to significantly decrease the risk of development as well as progression of retinopathy and remains a cornerstone in the medical management of DR. Laser photocoagulation and vitrectomy are important tools for preventing severe visual loss from sight-threatening DR and its complications. New pharmacological therapies to target the underlying biochemical mechanisms that cause DR are also being evaluated in order to overcome the limitations of current treatment modalities. In this context, the role of protein kinase C inhibitors, intravitreal injections of steroids, vascular endothelial growth factor inhibitors, angiotensin converting enzyme inhibitors such as candesartan, and growth hormone inhibitors is promising. Although treatment can help prevent blindness in a majority of cases, the key variable in the success of therapy lies in identifying patients with retinopathy before their vision is affected. This calls for timely eye examination of diabetic patients. The present article is a comprehensive review of DR with special emphasis on its pathophysiology and management aspects.
糖尿病视网膜病变（DR）仍然是全球范围内导致失明的主要危险因素和病因之一。严格控制代谢和血压已被证明可显著降低视网膜病变发生及进展的风险，并且仍然是DR医学管理的基石。激光光凝术和玻璃体切除术是预防由威胁视力的DR及其并发症导致严重视力丧失的重要手段。为了克服当前治疗方式的局限性，针对导致DR的潜在生化机制的新药理学疗法也正在进行评估。在这种背景下，蛋白激酶C抑制剂、玻璃体内注射类固醇、血管内皮生长因子抑制剂、坎地沙坦等血管紧张素转换酶抑制剂以及生长激素抑制剂的作用前景广阔。尽管治疗在大多数情况下有助于预防失明，但治疗成功的关键变量在于在患者视力受到影响之前识别出患有视网膜病变的患者。这就需要对糖尿病患者进行及时的眼部检查。本文是对DR的全面综述，特别强调其病理生理学和管理方面。
