Cullen Eye Institute, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX, 77030, USA.
School of Medicine, Baylor College of Medicine, Houston, TX, USA.
Curr Diab Rep. 2019 Jul 29;19(9):68. doi: 10.1007/s11892-019-1188-4.
Diabetes mellitus is a global epidemic which is growing in prevalence, and diabetic macular edema (DME) is a leading cause of visual impairment among patients affected by this disease. Our objective is to review current and upcoming therapeutic approaches to DME.
Once considered the gold standard in treatment of DME, focal/grid laser is now reserved mostly for non-center-involving DME, while anti-vascular endothelial growth factor (anti-VEGF) therapy has become the first-line treatment. However, suboptimal responders to anti-VEGF and the burden of frequent injections have stimulated the development of novel approaches. Corticosteroids can be effective in treating DME, but adverse effects such as intraocular pressure elevation and cataract formation must be considered. Emerging therapeutics and drug delivery systems in the pipeline offer exciting potential solutions to this vision-threatening disease. Multiple types of therapeutics targeting various pathways implicated in the pathogenesis of DME may help lessen the global burden of vision loss from diabetes.
糖尿病是一种全球性的流行病，其患病率正在上升，糖尿病性黄斑水肿（DME）是该病患者视力损害的主要原因。我们的目的是综述 DME 的现有和即将出现的治疗方法。
曾经被认为是 DME 治疗的金标准，局灶/格栅激光现在主要保留用于非中心受累的 DME，而抗血管内皮生长因子（抗 VEGF）治疗已成为一线治疗。然而，抗 VEGF 的反应不佳者和频繁注射的负担刺激了新方法的发展。皮质类固醇在治疗 DME 方面可能有效，但必须考虑到眼压升高和白内障形成等不良反应。正在研发中的新型治疗药物和药物输送系统为这种威胁视力的疾病提供了令人兴奋的潜在解决方案。针对 DME 发病机制中涉及的各种途径的多种类型的治疗药物可能有助于减轻全球因糖尿病导致的视力丧失负担。
