Leung Vannessa, Wong James G, Grigg John R
Save Sight Institute Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Sydney Eye Hospital, Macquarie St, Sydney, NSW, 2000, Australia.
Doc Ophthalmol. 2025 Feb;150(1):41-46. doi: 10.1007/s10633-024-09999-2. Epub 2024 Dec 27.
Multiple mitochondrial syndromes, such as Kearns-Sayre, involve the concurrence of diabetes mellitus and inherited pigmentary retinopathy. It is rare, however, for proliferative disease to develop in these patients as existing inner retinal dysfunction is thought to be protective.
To our knowledge this is the first description of proliferative diabetic retinopathy (PDR) in Kearns-Sayre syndrome.
A number of additional considerations need to be recognised when treating PDR in Kearns-Sayre syndrome. Given the risk of further visual field losses with panretinal photocoagulation, there should be a preference for primary anti-VEGF therapy in a compliant patient. PDR in inherited retinal disease appears to be very anti-VEGF responsive and may not require the standard monthly frequency of treatment, even from initiation.
多种线粒体综合征，如卡恩斯-塞尔综合征，涉及糖尿病和遗传性色素性视网膜病变的并发。然而，这些患者发生增殖性疾病较为罕见，因为现有的视网膜内层功能障碍被认为具有保护作用。
据我们所知，这是首次对卡恩斯-塞尔综合征患者的增殖性糖尿病视网膜病变（PDR）进行描述。
在治疗卡恩斯-塞尔综合征患者的PDR时，需要认识到一些其他的注意事项。鉴于全视网膜光凝有进一步导致视野丧失的风险，对于依从性好的患者，应优先选择抗血管内皮生长因子（VEGF）初始治疗。遗传性视网膜疾病中的PDR似乎对抗VEGF治疗反应非常敏感，甚至从一开始可能就不需要标准的每月治疗频率。
