Chatziralli Irini P
2nd Department of Ophthalmology, University of Athens, Athens, Greece.
Diabetes Ther. 2017 Apr;8(2):209-212. doi: 10.1007/s13300-017-0240-0. Epub 2017 Feb 28.
Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered as the leading cause of visual impairment in working-aged adults worldwide. Dyslipidemia has been associated with DR, but not with progression to the proliferative form of DR, although the exact role in the pathogenesis of DR and diabetic macular edema (DME) remains controversial. As a result, a reasonable question arising is whether control of dyslipidemia may alter the course of DR. Statins do not appear to have an impact on DR progression. On the other hand, fenofibrate has been found to significantly reduce the rate of progression of DR in patients with pre-existing mild DR, although it has no impact on patient's vision nor on the prevention of DR development in patients with type 2 DM without DR. An interesting point that needs further evaluation is why patients without DR or those with severe DR appear to have no benefit from fenofibrate treatment.
糖尿病视网膜病变（DR）是糖尿病（DM）常见的微血管并发症，被认为是全球劳动年龄成年人视力损害的主要原因。血脂异常与DR有关，但与DR进展为增殖型无关，尽管其在DR和糖尿病性黄斑水肿（DME）发病机制中的确切作用仍存在争议。因此，一个合理的问题是，控制血脂异常是否会改变DR的病程。他汀类药物似乎对DR进展没有影响。另一方面，已发现非诺贝特可显著降低已有轻度DR患者的DR进展率，尽管它对患者视力没有影响，也不能预防无DR的2型糖尿病患者发生DR。一个需要进一步评估的有趣问题是，为什么没有DR的患者或患有严重DR的患者似乎不能从非诺贝特治疗中获益。
