抗血管内皮生长因子药物在增生型糖尿病视网膜病变中的应用新进展

既往全视网膜激光光凝(PRP)和玻璃体切割手术(PPV)是增生型糖尿病视网膜病变(PDR)最主要的治疗方法。近年,抗血管内皮生长因子(VEGF)药物因其可以迅速消退新生血管、减少渗漏、促进积血吸收等优势已在PDR中应用得越来越广泛。抗VEGF药物联合PRP治疗PDR,尤其是高危PDR,可以提高新生血管消退率,并且可使部分轻中度玻璃体积血患者避免行PPV。在PPV围手术期应用抗VEGF药物也可减少手术中出血,缩短手术时间,降低手术并发症的发生率。尽管临床研究已证实抗VEGF药物可以作为PRP的替代治疗,但由于大多患者需要多次、长期治疗,增加了患者的心理和经济负担,期待未来抗VEGF药物成本的降低和长效剂型的开发可以为PDR患者带来更好的疗效和益处。

New progress in the application of anti-vascular endothelial growth factor drugs in proliferative diabetic retinopathy

In the past,panretinal photocoagulation(PRP)and vitrectomy(PPV)were the main treatments for proliferative diabetic retinopathy(PDR).In recent years,anti-vascular endothelial growth factor(VEGF)drugs have been used more and more widely in PDR due to their advantages in rapidly subtracting new blood vessels,reducing leakage,and promoting the absorption of blood.The combination of anti-VEGF drugs and PRP in the treatment of PDR,especially high-risk PDR,can increase the rate of neovascularization and prevent some patients with mild to moderate vitreous hemorrhage from PPV.The application of anti-VEGF drugs during the perioperative period of PPV can also reduce bleeding during the operation,shorten the operation time,and reduce surgical complications.Although clinical studies have confirmed that anti-VEGF drugs can be used as an alternative treatment for PRP,most patients require multiple and long-term treatments,which increase the psychological and economic burden of patients.It is expected that the cost of anti-VEGF drugs and the development of long-acting dosage forms can be reduced and bring better efficacy and benefits to PDR patients in the future.