Körner F, Pournaras C
Universitäts-Augenklinik Inselspital, Bern.
Schweiz Rundsch Med Prax. 1990 Oct 9;79(41):1205-7.
The risk of blindness in diabetes may be significantly reduced by a suitable ophthalmic therapy. In order to apply this therapy in due time to the population at risk, all diabetics should be referred to ophthalmological follow-up examination at regular intervals. A rapid progression of a retinopathy may occur in young patients, especially during puberty and pregnancy, after change from oral antidiabetics to insulin and, temporarily, following strict control of blood glucose. Besides normoglycemia, the prevention of a high blood pressure is an important prerequisite of an efficient treatment of diabetic retinopathy. Retinal photocoagulation has been proven the most effective mode of therapy. The correct indication and stage-depending dosage of retinal laser coagulation in diabetes is a demanding task which should be reserved to well-trained specialists in this field. Diabetic vitreous bleeding and retinal traction detachment are complications of advanced proliferative diabetic retinopathy, which can be treated successfully in 60-70% of the cases by modern techniques of vitreoretinal surgery.
适当的眼科治疗可显著降低糖尿病患者失明的风险。为了及时对高危人群应用这种治疗方法，所有糖尿病患者都应定期接受眼科随访检查。视网膜病变可能在年轻患者中迅速发展，尤其是在青春期和怀孕期间，从口服降糖药改用胰岛素后，以及在血糖严格控制期间暂时出现。除了血糖正常外，预防高血压是有效治疗糖尿病视网膜病变的重要前提。视网膜光凝已被证明是最有效的治疗方式。糖尿病视网膜激光光凝的正确适应症和根据分期的剂量是一项要求很高的任务，应由该领域训练有素的专家来完成。糖尿病性玻璃体出血和视网膜牵拉性脱离是晚期增殖性糖尿病视网膜病变的并发症，通过现代玻璃体视网膜手术技术，60%-70%的病例可以成功治疗。
