国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (2): 124-128.doi: 10.3760/cma.j.cn115500-20240921-25208

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玻璃体切除术后糖尿病性黄斑水肿的治疗现状

隋嘉嘉  陆桂红  朱蓉嵘   

  1. 南通大学附属医院眼科,南通大学医学院,江苏南通 226001
  • 收稿日期:2024-09-21 出版日期:2025-04-22 发布日期:2025-04-10
  • 通讯作者: 朱蓉嵘,Email:zrreye@126.com

Treatment status of diabetic macular edema after par plana vitrectomy

Sui Jiajia, Lu Guihong, Zhu Rongrong   

  1. Department of Ophthalmology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong Jiangsu 226001, China
  • Received:2024-09-21 Online:2025-04-22 Published:2025-04-10
  • Contact: Zhu Rongrong, Email: zrreye@126.com

摘要: 糖尿病性黄斑水肿(diabetic macular edema,DME)是糖尿病性视网膜病变(diabetic retinopathy,DR)患者视力丧失的主要原因,可发生在DR的任何阶段。由于其发病机制复杂, DME的治疗仍是挑战。当DR进展至玻璃体积血或视网膜脱离时常需行玻璃体切除术(par plana vitrectomy,PPV),术后玻璃体内炎症因子及药代动力学会发生改变。对于PPV术后的DME,需要调整抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物的剂量或缩短其注射间隔;玻璃体内注射抗炎药物或抗VEGF联合抗炎药物治疗应作为PPV术后DME的首选治疗方法。目前对于PPV术后DME的治疗方案相关文献及研究较少,且缺乏相关治疗的共识。(国际眼科纵览,2025, 49:124-128

关键词: 糖尿病性黄斑水肿, 玻璃体切除术

Abstract: Diabetic macular edema (DME) is the leading cause of vision loss in patients with diabetic retinopathy (DR) and can occur at any stage of DR. The treatment of DME remains a challenge due to its complex pathogenesis. When DR progresses to vitreous hemorrhage or retinal detachment, vitrectomy (par plana vitrectomy (PPV)) is often required, after which the inflammatory factors and pharmacokinetics in the vitreous cavity are altered, and adjustment of the dose and injection interval of anti-vascular endothelial growth factor (VEGF) may be required for DME after PPV.  Intravitreal injections of anti-inflammatory drugs or anti-VEGF combined with anti-inflammatory drug therapy should be the first choice of treatment for DME after PPV. Currently, there are fewer reports in the literature and studies on the treatment options for DME after PPV, and there is a lack of relevant treatment consensus. (Int Rev Ophthalmol, 2025, 49:  124-128)

Key words: diabetic macular edema, par plana vitrectomy