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西班牙临床实践中糖尿病性黄斑水肿患者的管理

Management of diabetic macular edema patients in clinical practice in Spain.

作者信息

Abreu-Gonzalez Rodrigo, Gallego-Pinazo Roberto, Abraldes Maximino, Pinilla Isabel, Lopez-Galvez María I

机构信息

Ophthalmology Center, University Hospital of La Candelaria, Tenerife, Spain.

Oftalvist Clinic, Valencia, Spain.

出版信息

Eur J Ophthalmol. 2019 Nov;29(6):664-672. doi: 10.1177/1120672118804079. Epub 2018 Oct 7.

Abstract

PURPOSE

Diabetic macular edema is the main cause of blindness in diabetic patients. Vascular endothelial growth factor is involved in diabetic macular edema pathogenesis. Vascular endothelial growth factor inhibitors are an important option in diabetic macular edema therapy. This survey investigates actual clinical practice in diabetic macular edema in Spain.

METHODS

An expert advisory panel of 17 Spanish ophthalmologists developed a 30-item anonymous questionnaire about diagnosis, treatment, and follow-up in diabetic macular edema. A total of 137 ophthalmologists from 10 Spanish regions completed the questionnaire online.

RESULTS

Almost all of the respondents (99.3%) record the measured visual acuity and perform biomicroscopic anterior (94.9%) and posterior (91.2%) segment examinations. Similarly, 100% of responding ophthalmologists always/almost always or frequently perform optical coherence tomography. Most respondents (65%) always/almost always or frequently perform a retinography. More than 50% rarely perform fluorescein angiography. Nearly, all (96.4%) of the specialists responded that, in center-involved diabetic macular edema, the first treatment is an anti-vascular endothelial growth factor drug. For corticosteroids, the first choice of most respondents (91.2%) was the dexamethasone implant. In the follow-up, almost all (96.4%) specialists record the measured visual acuity and most also perform biomicroscopic anterior (82.5%) and posterior (83.2%) segment examination.

CONCLUSION

This survey shows the actual clinical practice in diabetic macular edema in Spain, finding that anti-vascular endothelial growth factor therapy is frequently used, and that diagnosis, treatments, and follow-up examinations used by specialists are homogeneous and according to diabetic macular edema guidelines.

摘要

目的

糖尿病性黄斑水肿是糖尿病患者失明的主要原因。血管内皮生长因子参与糖尿病性黄斑水肿的发病机制。血管内皮生长因子抑制剂是糖尿病性黄斑水肿治疗的重要选择。本调查旨在研究西班牙糖尿病性黄斑水肿的实际临床实践情况。

方法

由17名西班牙眼科医生组成的专家咨询小组编制了一份关于糖尿病性黄斑水肿诊断、治疗和随访的30项匿名问卷。来自西班牙10个地区的137名眼科医生在线完成了该问卷。

结果

几乎所有受访者(99.3%)都记录测量的视力,并进行眼前节(94.9%)和眼后节(91.2%)生物显微镜检查。同样,100%的受访眼科医生总是/几乎总是或经常进行光学相干断层扫描。大多数受访者(65%)总是/几乎总是或经常进行视网膜造影。超过50%的人很少进行荧光素血管造影。几乎所有(96.4%)专家表示,在累及黄斑中心凹的糖尿病性黄斑水肿中,首选治疗是抗血管内皮生长因子药物。对于皮质类固醇,大多数受访者(91.2%)首选地塞米松植入剂。在随访中,几乎所有(96.4%)专家记录测量的视力,大多数还进行眼前节(82.5%)和眼后节(83.2%)生物显微镜检查。

结论

本次调查展示了西班牙糖尿病性黄斑水肿的实际临床实践情况,发现抗血管内皮生长因子疗法被频繁使用,并且专家们采用的诊断、治疗和随访检查是一致的,且符合糖尿病性黄斑水肿指南。

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