Francisco Rosa Stefanini, Maurício Maia, The Retina Division, Ophthalmology Department, Federal University of São Paulo, São Paulo, SP 04023-062, Brazil.
World J Diabetes. 2013 Apr 15;4(2):19-26. doi: 10.4239/wjd.v4.i2.19.
Diabetic retinopathy (DR) is a leading cause of vision loss in the working-age population and is relatedto 1%-5% of cases of blindness worldwide. Diabetic macular edema (DME) is the most frequent cause of DR vision loss and is an important public health problem. Recent studies have implicated vascular endothelial growth factor (VEGF) in DR and DME pathogenesis, as well as provided evidence of the benefits of anti-VEGF agents for the management of such conditions. Despite the benefits of intravitreal ranibizumab injection for the management of DME, the cost-effectiveness of intravitreal bevacizumab therapy has gained increasing interest in the scientific community. This review summarizes the studies examining bevacizumab for the management of DME, focusing on the efficacy and duration of the clinical benefits of decreasing DME and the improvement of best-corrected visual acuity (BCVA). There is strong evidence that intravitreal bevacizumab injection therapy has a good cost-effective profile in the management of DME and may be associated with laser photocoagulation; however, its clinical superiority in terms of the duration of DME regression and the improvement of BCVA compared with intravitreal ranibizumab and other intravitreal anti-VEGF therapies remains unclear and deserves further investigation.
糖尿病性视网膜病变（DR）是导致工作年龄人群视力丧失的主要原因，也是全球 1%-5%的失明病例的病因。糖尿病性黄斑水肿（DME）是 DR 视力丧失的最常见原因，也是一个重要的公共卫生问题。最近的研究表明，血管内皮生长因子（VEGF）在 DR 和 DME 的发病机制中起作用，并为抗 VEGF 药物治疗这些疾病的益处提供了证据。尽管玻璃体内雷珠单抗注射治疗 DME 具有益处，但玻璃体内贝伐单抗治疗的成本效益在科学界引起了越来越多的关注。这篇综述总结了评估贝伐单抗治疗 DME 的研究，重点关注降低 DME 和改善最佳矫正视力（BCVA）的临床益处的持续时间和疗效。有强有力的证据表明，玻璃体内贝伐单抗注射疗法在 DME 的管理中有良好的成本效益，并且可能与激光光凝联合使用；然而，与玻璃体内雷珠单抗和其他玻璃体内抗 VEGF 疗法相比，其在 DME 消退的持续时间和 BCVA 的改善方面的临床优越性仍不清楚，值得进一步研究。
