Eye Department, Royal Hallamshire Hospital, Sheffield, UK.
Eye (Lond). 2012 Apr;26 Suppl 2(Suppl 2):S1-16. doi: 10.1038/eye.2012.32.
Retinal vascular diseases are a leading cause of blindness in the Western world. Advancement in the clinical management of these diseases has been fast-paced, with new treatments becoming available as well as license extensions of existing treatments. Vascular endothelial growth factor (VEGF) has been implicated in certain retinal vascular diseases, including wet age-related macular degeneration (AMD), diabetic macular oedema (DMO), and retinal vein occlusion (RVO). Treatment of wet AMD and visual impairment due to either DMO or macular oedema secondary to RVO with an anti-VEGF on an as needed basis, rather than a fixed schedule, allows an individualised treatment approach; providing treatment when patients are most likely to benefit from it, while minimising the number of unnecessary intravitreal injections. Thus, an individualised treatment regimen reduces the chances of over-treatment and under-treatment, optimising both the risk/benefit profile of the treatment and the efficient use of NHS resource. Streamlining of treatment for patients with wet AMD and visual impairment due to either DMO or macular oedema secondary to RVO, by using one treatment with similar posology across all three diseases, may help to minimise burden of clinic capacity and complexity and hence optimise patient outcomes. Informed treatment decisions and efficient clinic throughput are important for optimal patient outcomes in the fast-changing field of retinal vascular diseases.
视网膜血管疾病是西方世界致盲的主要原因。这些疾病的临床管理进展迅速，新的治疗方法不断涌现，现有的治疗方法也获得了许可扩展。血管内皮生长因子（VEGF）与某些视网膜血管疾病有关，包括湿性年龄相关性黄斑变性（AMD）、糖尿病性黄斑水肿（DMO）和视网膜静脉阻塞（RVO）。湿性 AMD 以及由 DMO 或继发于 RVO 的黄斑水肿引起的视力障碍，按需而非固定时间间隔用抗 VEGF 治疗，允许采用个体化治疗方法；在患者最有可能受益的情况下提供治疗，同时最大限度地减少不必要的玻璃体内注射次数。因此，个体化治疗方案可降低过度治疗和治疗不足的可能性，优化治疗的风险/获益情况并提高 NHS 资源的使用效率。对于湿性 AMD 以及由 DMO 或继发于 RVO 的黄斑水肿引起的视力障碍患者，通过使用三种疾病中均具有相似治疗方案的一种治疗方法，可有助于最大限度地减少临床容量和复杂性负担，从而优化患者的治疗效果。在快速变化的视网膜血管疾病领域，明智的治疗决策和高效的临床治疗流程对于获得最佳患者治疗效果非常重要。
