J Fernando Arevalo, Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
World J Diabetes. 2013 Dec 15;4(6):231-3. doi: 10.4239/wjd.v4.i6.231.
Diabetic retinopathy (DR) is the leading cause of vision loss of working-age adults, and diabetic macular edema (DME) is the most frequent cause of vision loss related to diabetes. The Wisconsin Epidemiologic Study of Diabetic Retinopathy found the 14-year incidence of DME in type 1 diabetics to be 26%. Similarly the Diabetes Control and Complications Trial reported that 27% of type 1 diabetic patients develop DME within 9 years of onset. The most common type of diabetes, type 2, is strongly associated with obesity and a sedentary lifestyle. An even higher incidence of macular edema has been reported in older patients with type 2 diabetes. Within the last 5 years, the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor (VEGF) agents have come into clinical practice for the management of DME and several recent randomized clinical trials have shown improved effectiveness of ranibizumab compared to focal/grid laser. In this theme issue, we discuss the classification of DR and the treatment options currently available for the treatment of DME including corticosteroids, anti-VEGF agents, combined therapy, enzymatic vitrectomy (vitreolysis), and new therapies.
糖尿病性视网膜病变（DR）是导致工作年龄段成年人视力丧失的主要原因，而糖尿病性黄斑水肿（DME）是与糖尿病相关的最常见的视力丧失原因。威斯康星州糖尿病性视网膜病变的流行病学研究发现，1 型糖尿病患者中 DME 的 14 年发病率为 26%。同样，糖尿病控制和并发症试验报告说，1 型糖尿病患者中有 27%在发病后 9 年内出现 DME。最常见的糖尿病类型 2 型与肥胖和久坐的生活方式密切相关。在年龄较大的 2 型糖尿病患者中，黄斑水肿的发生率更高。在过去的 5 年中，玻璃体内皮质类固醇和玻璃体内抗血管内皮生长因子（VEGF）药物的使用已进入临床实践，用于治疗 DME，并且最近的几项随机临床试验表明，与局部/格栅激光相比，雷珠单抗的疗效有所提高。在本期特刊中，我们讨论了 DR 的分类以及目前可用于治疗 DME 的治疗选择，包括皮质类固醇、抗 VEGF 药物、联合治疗、酶玻璃体切除术（玻璃体溶解）和新疗法。
