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糖尿病视网膜病变——筛查与治疗建议

Diabetic retinopathy-recommendations for screening and treatment.

作者信息

Pedrini Alisa, Nowosielski Yvonne, Rehak Matus

机构信息

Department of Ophthalmology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.

出版信息

Wien Med Wochenschr. 2025 Jun;175(9-10):253-263. doi: 10.1007/s10354-025-01088-6. Epub 2025 May 9.

Abstract

Diabetic retinopathy (DR), the prevalence of which continues to rise, is one of the most common causes of vision loss worldwide. Experimental and clinical research in recent years has contributed to a better understanding of the pathogenesis of DR, which is complex and results from many interrelated processes leading to abnormal permeability and occlusion of the retinal vasculature, with ischemia and subsequent neovascularization. According to the absence or presence of neovascularization, DR is divided into two main forms: nonproliferative and proliferative DR. From nonproliferative to proliferative disease, diabetic macular edema (DME) can develop anywhere along the spectrum. As the majority of diabetics have no ophthalmologic symptoms, screening plays an important role in preventing the development of retinal disease. Specific treatment options beyond metabolic risk factor control, including intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents or corticosteroids, laser photocoagulation, and vitreous surgery, are effective approaches for ocular diabetic complications.

摘要

糖尿病视网膜病变(DR)的患病率持续上升,是全球视力丧失的最常见原因之一。近年来的实验和临床研究有助于更好地理解DR的发病机制,其机制复杂,是由许多相互关联的过程导致视网膜血管异常通透性和阻塞,并伴有缺血及随后的新生血管形成。根据有无新生血管形成,DR分为两种主要形式:非增殖性和增殖性DR。从非增殖性疾病发展到增殖性疾病的过程中,糖尿病性黄斑水肿(DME)可在整个病程的任何阶段发生。由于大多数糖尿病患者没有眼部症状,筛查在预防视网膜疾病发展方面起着重要作用。除了控制代谢危险因素外,特定的治疗选择,包括玻璃体内注射抗血管内皮生长因子(VEGF)药物或皮质类固醇、激光光凝和玻璃体手术,是治疗眼部糖尿病并发症的有效方法。

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