Wang Siyu, Hua Rui, Zhao Yuqi, Liu Limin
Department of Ophthalmology, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Bei Street, Heping District, Shenyang 110001, China.
J Clin Med. 2024 Sep 13;13(18):5439. doi: 10.3390/jcm13185439.
: Diabetic retinopathy (DR), as a complication of diabetes mellitus (DM), remains a significant contributor to preventable vision impairment in the working-age population. Laser photocoagulation is essential in treating DR in conjunction with anti-vascular endothelial growth factor (VEGF) injection, steroids, and vitrectomy. This review summarizes the history of laser photocoagulation and highlights its current role and long-term effectiveness in real-world conditions. : The National Clinical Trial (NCT), PubMed, Google Scholar, and China National Knowledge Infrastructure (CNKI) databases were searched utilizing combined or individual keywords, and a total of 121 articles were reviewed by the authors. : Several novel laser photocoagulation technologies, such as patterned scanning laser, subthreshold micropulse laser, navigated laser, multimodal imaging-guided laser, and retina rejuvenation therapy, substantially decrease the adverse effects and improve the accuracy and security of laser therapy. Numerous studies have demonstrated the outstanding clinical efficacy of combination therapies with pharmacologic treatments like anti-VEGF in treating DR and diabetic macular edema (DME). A 20-year follow-up retrospective study in our center preliminarily demonstrated the long-term effectiveness of conventional laser photocoagulation. : More clinical trials are required to confirm the clinical effectiveness of novel laser technologies. Better treatment protocols for the combination therapy may be detailed. Anti-VEGF treatment has better effects, especially for DME and in a short period. But in real-world conditions, given the long-term effectiveness and economic advantages of conventional laser treatment, it should be prioritized over anti-VEGF injection in certain situations.
糖尿病视网膜病变（DR）作为糖尿病（DM）的一种并发症，仍然是导致工作年龄人群可预防性视力损害的重要因素。激光光凝术结合抗血管内皮生长因子（VEGF）注射、类固醇和玻璃体切除术在治疗DR中至关重要。本综述总结了激光光凝术的历史，并强调了其在实际临床中的当前作用和长期疗效。：利用组合或单个关键词检索了国家临床试验（NCT）、PubMed、谷歌学术和中国知网（CNKI）数据库，作者共审阅了121篇文章。：几种新型激光光凝技术，如模式扫描激光、阈下微脉冲激光、导航激光、多模态成像引导激光和视网膜修复治疗，可显著减少不良反应，提高激光治疗的准确性和安全性。大量研究表明，抗VEGF等药物联合治疗在治疗DR和糖尿病性黄斑水肿（DME）方面具有显著的临床疗效。我们中心的一项为期20年的随访回顾性研究初步证明了传统激光光凝术的长期疗效。：需要更多的临床试验来证实新型激光技术的临床疗效。联合治疗可能需要更详细的治疗方案细节。抗VEGF治疗效果更好，尤其是对DME且在短期内。但在实际临床中，如果考虑到传统激光治疗的长期疗效和经济优势，在某些情况下应优先于抗VEGF注射治疗。
