Department of Ophthalmology, Clinical Hospital Dubrava, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia.
Mediators Inflamm. 2013;2013:213130. doi: 10.1155/2013/213130. Epub 2013 Oct 28.
Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus, is estimated to be the leading cause of new blindness in the working population of developed countries. Primary interventions such as intensive glycemic control, strict blood pressure regulation, and lipid-modifying therapy as well as local ocular treatment (laser photocoagulation and pars plana vitrectomy) can significantly reduce the risk of retinopathy occurrence and progression. Considering the limitations of current DR treatments development of new therapeutic strategies, it becomes necessary to focus on pharmacological treatment. Currently, there is increasing evidence that inflammatory processes have a considerable role in the pathogenesis of DR with multiple studies showing an association of various systemic as well as local (vitreous and aqueous fluid) inflammatory factors and the progression of DR. Since inflammation is identified as a relevant mechanism, significant effort has been directed to the development of new concepts for the prevention and treatment of DR acting on the inflammatory processes and the use of pharmacological agents with anti-inflammatory effect. Inhibiting the inflammatory pathway could be an appealing treatment option for DR in future practices, and as further prospective randomized clinical trials accumulate data, the role and guidelines of anti-inflammatory pharmacologic treatments will become clearer.
糖尿病视网膜病变（DR）是糖尿病最常见的微血管并发症，据估计是发达国家工作人群新发失明的主要原因。强化血糖控制、严格血压调节、血脂调节治疗以及局部眼部治疗（激光光凝和玻璃体切割术）等主要干预措施可以显著降低视网膜病变发生和进展的风险。鉴于目前 DR 治疗方法的局限性，有必要开发新的治疗策略，因此有必要专注于药物治疗。目前越来越多的证据表明，炎症过程在 DR 的发病机制中起着重要作用，多项研究表明，各种全身和局部（玻璃体和房水）炎症因子与 DR 的进展有关。由于炎症被确定为一种相关机制，因此人们已经做出了巨大的努力，开发出针对炎症过程的新的 DR 预防和治疗概念，并使用具有抗炎作用的药物。抑制炎症途径可能是未来 DR 治疗的一个有吸引力的选择，随着进一步的前瞻性随机临床试验积累数据，抗炎药物治疗的作用和指南将变得更加清晰。
