Massachusetts Eye and Research Surgery Institution, Cambridge, Mass., USA.
Can J Ophthalmol. 2010 Oct;45(5):501-8. doi: 10.3129/i10-023.
Diabetes mellitus is a major health concern in the modern world. Several sight-threatening ocular conditions are included in the array of health problems associated with this disease. Understandably, 2 of the more sight-threatening problems, proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME), have received a great deal of attention in recent years. Pivotal studies, such as the Early Treatment Diabetic Retinopathy Study and the Diabetic Retinopathy Study, have established laser photocoagulation as the accepted treatment modality. The last decade has seen a surge in clinical data supporting the use of pharmacologic therapy in place of the often damaging laser therapy. Supporting data are based on the establishment of vascular endothelial growth factor (VEGF) as a key facilitator of disease progression in diabetic retinopathy. We will discuss the advantages and disadvantages of both selective and pan-blockade anti-VEGF agents available today in an effort to help guide physicians wishing to use these agents to treat PDR and DME.
糖尿病是现代社会的一个主要健康关注点。在与这种疾病相关的一系列健康问题中，有几种威胁视力的眼部疾病。可以理解的是，在近年来，增殖性糖尿病性视网膜病变（PDR）和糖尿病性黄斑水肿（DME）这两种更具威胁性的眼部疾病受到了极大的关注。关键性研究，如糖尿病性视网膜病变早期治疗研究和糖尿病视网膜病变研究，已经确立了激光光凝作为公认的治疗方式。过去十年中，临床数据大量涌现，支持在糖尿病性视网膜病变中使用药物治疗来替代常常具有破坏性的激光治疗。支持性数据基于将血管内皮生长因子（VEGF）确立为疾病进展的关键促进因子。我们将讨论当今可用的选择性和全阻断抗 VEGF 药物的优缺点，以帮助指导希望使用这些药物治疗 PDR 和 DME 的医生。
