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[糖尿病性黄斑病变。诊断与治疗]

[Diabetic maculopathy. Diagnosis and treatment].

作者信息

Gelisken F, Ziemssen F

机构信息

Abteilung für Augenheilkunde, Eberhard-Karl-Universität Tübingen, Schleichstrasse 12, 72076, Tübingen, Germany.

出版信息

Ophthalmologe. 2010 Aug;107(8):773-86; quiz 787-8. doi: 10.1007/s00347-010-2202-z.

Abstract

Due to demographic change the incidence of diabetic retinopathy has risen in spite of new facilities and prevention campaigns and is still one of the leading causes of blindness in Germany. The combination of focal/grid laser photocoagulation and an intravitreal anti-VEGF (vascular endothelial growth factor) regimen is the first line approach for clinically significant macular edema with foveal involvement and is evidence-based. Vitreomacular interface abnormalities can be effectively treated by modern vitreomacular surgery. Unfortunately, no proven treatment modality can be provided for ischemic maculopathy. The management of systemic risks factors, such as hyperglycemia and arterial hypertension, remains a task of great importance despite all modifications and increase of knowledge during recent years. Innovative developments in the field of intravitreal pharmacotherapy have opened up new vistas. There are good prospects that modern ophthalmology will not be limited to preserving visual function but to allow improvements and consequently enhance health-related quality of life for diabetic patients.

摘要

由于人口结构变化,尽管有新的设施和预防运动,糖尿病视网膜病变的发病率仍在上升,并且仍是德国失明的主要原因之一。对于累及黄斑中心凹的具有临床意义的黄斑水肿,局部/格栅激光光凝与玻璃体内抗血管内皮生长因子(VEGF)治疗方案联合是一线治疗方法,且有循证依据。现代玻璃体黄斑手术可有效治疗玻璃体黄斑界面异常。遗憾的是,对于缺血性黄斑病变尚无经证实的治疗方式。尽管近年来有各种改进且知识不断增加,但控制全身危险因素,如高血糖和动脉高血压,仍然是一项极为重要的任务。玻璃体内药物治疗领域的创新发展开辟了新前景。现代眼科有望不仅局限于保留视功能,还能实现改善,从而提高糖尿病患者与健康相关的生活质量。

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