Freyler H
Wien Klin Wochenschr. 1977 Feb 10;89(4):101-6.
Adequate control of diabetic patients may not only delay the appearance of diabetic retinopathy, but may, moreover, effect the regression of fundus changes at the pre-retinopathic stage and in cases of commencing non-proliferative retinopathy. Medical treatment is based on the achievement of a decrease in vascular permeability and a lowering of the blood lipid level; a diet enriched with phosphates may influence retinal hypoxia by increasing the 2,3 diphosphoglycerate level in the erythrocytes, thereby leading to an improved free oxygen supply to the tissue. Complete medical and dietetic compensation of hyper-permeability of the retinal capillaries, of the intraretinal exudation of lipoproteins, and of retinal hypoxia belong still today to utopia; hence, conservative treatment is only of auxiliary character. Hypophysectomy has largely been abandoned in view of the mutilation involved and the poor results of this procedure. The most effective active treatment is photocoagulation. The best results are obtained by a combination of generalized unselective coagulation of the peripheral retina by means of a xenon coagulator and the selective elimination of progressive vascular changes seen in the fluorescein angiogram with argon laser.
对糖尿病患者进行充分控制不仅可以延缓糖尿病性视网膜病变的出现，而且还可能使视网膜病变前期以及非增殖性视网膜病变初发时的眼底改变消退。药物治疗的基础是降低血管通透性和降低血脂水平；富含磷酸盐的饮食可通过提高红细胞内2,3 - 二磷酸甘油酸水平来影响视网膜缺氧，从而改善组织的游离氧供应。对视网膜毛细血管高通透性、视网膜内脂蛋白渗出以及视网膜缺氧进行完全的药物和饮食补偿在当今仍然是不切实际的幻想；因此，保守治疗仅具有辅助作用。鉴于垂体切除术涉及身体损伤且该手术效果不佳，它在很大程度上已被摒弃。最有效的积极治疗方法是光凝术。通过氙气凝固器对周边视网膜进行全身性非选择性凝固，以及用氩激光选择性消除荧光素血管造影中所见的进行性血管改变相结合，可取得最佳效果。
