Alghadyan Abdulrahman A
Department of Ophthalmology, Dammam University, Dammam, Saudi Arabia.
Saudi J Ophthalmol. 2011 Apr;25(2):99-111. doi: 10.1016/j.sjopt.2011.01.009. Epub 2011 Jan 31.
Management of diabetes should involve both systemic and ocular aspects. Control of hyperglycemia, hypertension and dyslipidemia are of major role in the management of diabetic retinopathy. In the ocular part; laser treatment remains the cornerstone of treatment of diabetic macular edema (focal/grid), severe non-proliferative and proliferative diabetic retinopathy (panretinal photocoagulation). There is a strong support to combination therapy. Using one or two intravitreal injections such as anti-VEGF and or steroid to reduce central macular thickness followed by focal or grid laser to give a sustained response may offer an alternative to treatment in diabetic macular edema. Anti-VEGF were found to be effective as an adjunct therapy in proliferative diabetic retinopathy patient who is going to have vitrectomy for vitreous hemorrhage with neovascularization, panretinal photocoagulation, and other ocular surgery such as cases with neovascular glaucoma and cataract with refractory macular edema.
糖尿病的管理应涉及全身和眼部两个方面。控制高血糖、高血压和血脂异常在糖尿病视网膜病变的管理中起主要作用。在眼部方面，激光治疗仍然是糖尿病性黄斑水肿（局部/格栅）、重度非增殖性和增殖性糖尿病视网膜病变（全视网膜光凝）治疗的基石。联合治疗有强有力的支持依据。使用一或两种玻璃体内注射药物，如抗血管内皮生长因子（anti-VEGF）和/或类固醇，以减少中心黄斑厚度，随后进行局部或格栅激光治疗以获得持续反应，这可能为糖尿病性黄斑水肿的治疗提供一种替代方案。在患有玻璃体出血伴新生血管形成、需要进行玻璃体切除术的增殖性糖尿病视网膜病变患者、全视网膜光凝以及其他眼部手术（如新生血管性青光眼和伴有难治性黄斑水肿的白内障病例）中，抗血管内皮生长因子被发现作为辅助治疗有效。
