Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Curr Pharm Biotechnol. 2011 Mar 1;12(3):406-9. doi: 10.2174/138920111794480543.
Diabetic retinopathy remains a major cause of worldwide preventable blindness. The vitreo-retinal interface plays a critical role in the pathogenesis of diabetic retinopathy. The term pharmacologic vitreolysis refers to the use of enzymes to liquefy the vitreous gel, and to induce posterior vitreous detachment (PVD). Intravitreal ovine hyaluronidase injection was effective in clearing vitreous hemorrhage. Several human case series demonstrated that intravitreal injection of autologous plasmin enzyme was a safe and effective adjunct to vitreous surgery for the treatment of diabetic macular edema and proliferative diabetic retinopathy. Recently, it was shown that intravitreal injection of plasmin enzyme without the performance of vitrectomy induced complete PVD and reduced macular thickening due to refractory diabetic macular edema.
糖尿病性视网膜病变仍然是全球可预防失明的主要原因。玻璃体视网膜界面在糖尿病性视网膜病变的发病机制中起着关键作用。术语“药理玻璃体溶解”是指使用酶使玻璃体凝胶液化，并诱导玻璃体后脱离（PVD）。玻璃体内注射绵羊透明质酸酶可有效清除玻璃体积血。几项人类病例系列研究表明，玻璃体内注射自体纤溶酶是玻璃体手术治疗糖尿病性黄斑水肿和增生性糖尿病性视网膜病变的一种安全有效的辅助手段。最近的研究表明，玻璃体内注射纤溶酶而不进行玻璃体切除术可引起完全的 PVD，并减少由于难治性糖尿病性黄斑水肿引起的黄斑增厚。
