Current situation and research progress of clinical treatment of
diabetic retinopathy

doi:10.3760/cma.j.issn.1007-1245.2022.08.035

Abstract

Abstract:

Diabetic retinopathy (DR) is a local retinal microangiopaplasia in diabetic patients caused by long-term high blood glucose level, which can cause various degrees of visual impairment and is the main cause of blindness. The occurrence of DR is related to many factors and its pathogenesis is very complicated. At present, the clinical therapeutic methods of DR are varied, but the efficacy is different. With the development of pathogenesis of DR, many therapeutic methods have been proposed. This paper reviews the pathogenesis and clinical treatment status of DR based on previous research reports, aiming to provide references for clinical practice.

Key words:

"> Diabetic retinopathy, Pathogenesis, Treatment program, Research progress

摘要： 糖尿病视网膜病变（DR）为长期高血糖导致的糖尿病患者视网膜局部微血管病变，可造成不同程度的视功能损害，是致盲的主要原因。DR的发生与多种因素有关，其发病机制也十分复杂。目前临床上DR的治疗方式多种多样，但疗效各异。随着DR发病机制研究的不断深入，多种治疗该病的方法被不断提出。本文结合既往的研究报道对DR的发病机制和临床治疗现状进行综述，旨在为临床提供参考。

关键词: 糖尿病视网膜病变, 发病机制, 治疗方案, 研究进展

Qin Shuipen. Current situation and research progress of clinical treatment of diabetic retinopathy[J]. International Medicine and Health Guidance News, 2022, 28(8): 1180-1184.

覃水喷. 糖尿病视网膜病变的临床治疗现状及研究进展[J]. 国际医药卫生导报, 2022, 28(8): 1180-1184.

References

[1] 李晓凤,金梅,林碧莹. 益气活血方剂治疗非增生性糖尿病视网膜病变的效果观察[J]. 国际医药卫生导报,2021,27(18):2849-2852. DOI:10.3760/cma.j.issn.1007-1245. 2021.18.012.

[2] Liu Y, Song Y, Tao L, et al. Prevalence of diabetic retinopathy among 13473 patients with diabetes mellitus in China: a cross-sectional epidemiological survey in six provinces[J]. Bmj Open, 2017, 7(1): e013199. DOI: 10.1136/bmjopen-2016-013199.

[3] Rodríguez ML, Pérez S, Mena-Mollá S, et al. Oxidative stress and microvascular alterations in diabetic retinopathy: future therapies[J]. Oxid Med Cell Longev, 2019, 2019: 4940825. DOI: 10.1155/2019/4940825.

[4] Van Hove I, De Groef L, Boeckx B, et al. Single-cell transcriptome analysis of the akimba mouse retina reveals cell-type-specific insights into the pathobiology of diabetic retinopathy[J]. Diabetologia, 2020, 63(10): 2235-2248. DOI: 10.1007/s00125-020-05218-0.

[5] Kinuthia UM, Wolf A, Langmann T. Microglia and inflammatory responses in diabetic retinopathy[J]. Front Immunol, 2020, 11: 564077. DOI: 10.3389/fimmu. 2020. 564077.

[6] Taghavi Y, Hassanshahi G, Kounis NG, et al. Monocyte chemoattractant protein-1 (MCP-1/CCL2) in diabetic retinopathy: latest evidence and clinical considerations[J]. J Cell Commun Signal, 2019, 13(4): 451-462. DOI: 10.1007/s12079-018-00500-8.

[7] Wang W, Lo ACY. Diabetic retinopathy: pathophysiology and treatments[J]. Int J Mol Sci, 2018, 19(6): 1816. DOI: 10.3390/ijms19061816.

[8] Hammes HP. Diabetic retinopathy: hyperglycaemia, oxidative stress and beyond[J]. Diabetologia, 2018, 61(1): 29-38. DOI: 10.1007/s00125-017-4435-8.

[9] Kang Q, Yang C. Oxidative stress and diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications[J]. Redox Biol, 2020, 37: 101799. DOI: 10.1016/j.redox.2020.101799.

[10] Wu MY, Yiang GT, Lai TT, et al. The oxidative stress and mitochondrial dysfunction during the pathogenesis of diabetic retinopathy[J]. Oxid Med Cell Longev, 2018, 2018: 3420187. DOI: 10.1155/2018/3420187.

[11] Xu X, Cai Y, Yu Y. Molecular mechanism of the role of carbamyl erythropoietin in treating diabetic retinopathy rats[J]. Exp Ther Med, 2018, 16(1): 305-309. DOI: 10.3892/etm.2018.6167.

[12] Dehdashtian E, Mehrzadi S, Yousefi B, et al. Diabetic retinopathy pathogenesis and the ameliorating effects of melatonin; involvement of autophagy, inflammation and oxidative stress[J]. Life Sci, 2018, 193: 20-33. DOI: 10.1016/j.lfs.2017.12.001.

[13] Shao K, Xi L, Cang Z, et al. Knockdown of NEAT1 exerts suppressive effects on diabetic retinopathy progression via inactivating TGF‐β1 and VEGF signaling pathways[J]. J Cell Physiol, 2020, 235(12): 9361-9369. DOI: 10.1002/jcp.29740.

[14] Cecilia OM, José Alberto CG, José NP, et al. Oxidative stress as the main target in diabetic retinopathy pathophysiology[J]. J Diabetes Res, 2019, 2019 :8562408. DOI: 10.1155/2019/8562408.

[15] Mahajan N, Arora P, Sandhir R. Perturbed biochemical pathways and associated oxidative stress lead to vascular dysfunctions in diabetic retinopathy[J]. Oxid Med Cell Longev, 2019, 2019: 8458472. DOI: 10.1155/2019/8458472.

[16] Mohammad G, Kowluru R A. Homocysteine disrupts balance between MMP-9 and its tissue inhibitor in diabetic retinopathy: the role of DNA methylation[J]. Int J Mol Sci, 2020, 21(5): 1771. DOI: 10.3390/ijms21051771

[17] Zhang H, Gao Y, Zhang J, et al. The effect of total lignans from fructus arctii on streptozotocin-induced diabetic retinopathy in Wistar rats[J]. J Ethnopharmacol, 2020, 255: 112773. DOI: 10.1016/j.jep.2020.112773

[18] Sarikaya M, Yazihan N, Daş Evcimen N. Relationship between aldose reductase enzyme and the signaling pathway of protein kinase C in an in vitro diabetic retinopathy model[J]. Can J Physiol Pharmacol, 2020, 98(4): 243-251. DOI: 10.1139/cjpp-2019-0211.

[19] Xu J, Chen LJ, Yu J, et al. Involvement of advanced glycation end products in the pathogenesis of diabetic retinopathy[J]. Cell Physiol Biochem, 2018, 48(2): 705-717. DOI: 10.1159/000491897.

[20] Jiao W, Ji JF, Xu W, et al. Distinct downstream signaling and the roles of VEGF and PlGF in high glucose-mediated injuries of human retinal endothelial cells in culture[J]. Sci Rep, 2019, 9(1): 1-13. DOI: 10.1038/s41598-019- 51603-0.

[21] Kaštelan S, Orešković I, Bišćan F, et al. Inflammatory and angiogenic biomarkers in diabetic retinopathy[J]. Biochem Med (Zagreb), 2020, 30(3): 030502. DOI: 10.11613/BM.2020.030502.

[22] Qin YJ, Chan SO, Lin HL, et al. Increased expression of growth hormone–releasing hormone in fibrinous inflammation of proliferative diabetic retinopathy[J]. Am J Ophthalmol, 2020, 215: 81-90. DOI: 10.1016/j.ajo.2020.02.006.

[23] 高晔,孙桂波,罗云,等. 糖尿病视网膜病的发病机制及药物干预研究进展[J]. 中国药理学通报,2020,36(4):491-495. DOI:10.3969/j.issn.1001-1978.2020.04.009.

[24] El Rami H, Barham R, Sun JK, et al. Evidence-based treatment of diabetic retinopathy[J]. Semin Ophthalmol, 2017, 32(1): 67-74. DOI: 10.1080/08820538.2016. 1228397.

[25] Bahrami B, Hong T, Gilles MC, et al. Anti-VEGF therapy for diabetic eye diseases[J]. Asia Pac J Ophthalmol (Phila), 2017, 6(6): 535-545. DOI: 10.22608/APO.2017350.

[26] Sivaprasad S, Prevost AT, Vasconcelos JC, et al. Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial[J]. Lancet, 2017, 389(10085): 2193-2203. DOI: 10.1016/S0140-6736(17)31193-5.

[27] 肖巍,马雅娟,陈林秀,等.依帕司他片联合前列地尔注射剂治疗糖尿病视网膜病变的临床研究[J].中国临床药理学杂志,2018,34(8):934-937. DOI:10.13699/j.cnki.1001-6821. 2018.08.006.

[28] Whitehead M, Wickremasinghe S, Osborne A, et al. Diabetic retinopathy: a complex pathophysiology requiring novel therapeutic strategies[J]. Expert Opin Biol Ther, 2018, 18(12): 1257-1270. DOI: 10.1080/14712598. 2018.1545836.

[29] 姜宇欣. 糖尿病性视网膜病变的发病机制及治疗进展[J]. 上海医药,2020,41(11):61-64. DOI:10.3969/j.issn.1006- 1533.2020.11.019.

[30] Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes[J]. N Engl J Med, 2009, 360(2): 129-139. DOI: 10.1056/NEJMoa0808431.

[31] Liu Y, Li J, Ma J, et al. The threshold of the severity of diabetic retinopathy below which intensive glycemic control is beneficial in diabetic patients: Estimation using data from large randomized clinical trials[J]. J Diabetes Res, 2020, 2020: 8765139. DOI: 10.1155/2020/8765139.

[32] Maleškić S, Kusturica J, Gušić E, et al. Metformin use associated with protective effects for ocular complications in patients with type 2 diabetes- observational study[J]. Acta Med Acad, 2017, 46(2):116-123. DOI: 10.5644/ama2006-124.196.

[33] Ghamdi AHA. Clinical predictors of diabetic retinopathy progression; a systematic review[J]. Curr Diabetes Rev, 2020, 16(3): 242-247. DOI: 10.2174/1573399815666190215120435.

[34] Eguchi K. Blood pressure management in patients with type 2 diabetes[J]. Intern Med, 2015, 54(18): 2285-2289. DOI: 10.2169/internalmedicine.54.5617.

[35] 孙娟,何红. 糖尿病视网膜病变危险因素的研究进展[J]. 中华眼底病杂志,2020,36(12):986-990. DOI:10.3760/cma.j.cn511434-20191009-00317.

[36] Granado-Casas M, Ramírez-Morros A, Martín M, et al. Type 1 diabetic subjects with diabetic retinopathy show an unfavorable pattern of fat intake[J]. Nutrients, 2018, 10(9): 1184. DOI: 10.3390/nu10091184.

[37] Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial[J]. Lancet, 2007, 370(9600): 1687-1697. DOI: 10.1016/S0140-6736(07)61607-9.

[38] Lin KY, Hsih WH, Lin YB, et al. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy[J]. J Diabetes Investig, 2021, 12(8): 1322- 1325. DOI: 10.1111/jdi.13480.

[39] 杨艳风,程萍,魏婷. 玻璃体切除联合白内障手术治疗增生性糖尿病视网膜病变的疗效[J]. 国际眼科杂志,2018,18(3):544-546. DOI:10.3980/j.issn.1672-5123.2018.3.33.

[40] 张梦思,秦萍,徐利辉. 玻璃体腔注射雷珠单抗对增殖性糖尿病视网膜病变合并牵拉性视网膜脱离手术效果的影响[J]. 广东医学,2018,39(2):283-285. DOI:10.3969/j.issn.1001-9448.2018.02.029.

Current situation and research progress of clinical treatment of diabetic retinopathy

糖尿病视网膜病变的临床治疗现状及研究进展

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 13

Recommended Articles

Metrics

[1]	Li Nan, Cui Xiujuan, Ding Baijuan, Duan Chao, Shi Juanjuan. One case of misdiagnosed invasive fibroma on abdominal wall and literature review [J]. International Medicine and Health Guidance News, 2022, 28(9): 1209-1212.
[2]	Pei Mengge, Li Guqiang. Treatment strategies for shoulder-hand syndrome after stroke [J]. International Medicine and Health Guidance News, 2022, 28(9): 1326-1329.
[3]	Xin Jifu, Wuren Tuya, Qingge Letu. Changes of serum zinc, copper, and selenium concentrations in children and adolescents with myopia [J]. International Medicine and Health Guidance News, 2022, 28(8): 1066-1069.
[4]	Zhang Xueling, Huang Meiling, Liu Chunling, Sun Zhuoran. Application of a mixed teaching mode of gynecological and obstetric cases co-built by teachers from Guangdong and Macao [J]. International Medicine and Health Guidance News, 2022, 28(8): 1130-1134.
[5]	Fan Yuying, Ma Hongyan, Yu Wenjun, Zhang Yan. Application effect of chlorhexidine gluconate antibacterial transparent dressing in patients after lumbar cistern catheterization and its influence on infection rate [J]. International Medicine and Health Guidance News, 2022, 28(7): 989-991.
[6]	Li Fuyun, Xue Maifu. Therapeutic effect of methylprednisolone combined with lidocaine for refractory sudden deafness with tinnitus [J]. International Medicine and Health Guidance News, 2022, 28(6): 780-783.
[7]	Tian Jie, Jin Yu, Liu Suqin. Research progress of plastic bronchitis in children [J]. International Medicine and Health Guidance News, 2022, 28(6): 805-808.
[8]	Xing Xiaoyun, Ma Lei. Research progress of PI3K/AKT signaling pathway in pathogenesis of psoriasis [J]. International Medicine and Health Guidance News, 2022, 28(5): 594-597.
[9]	Gai Na, Liu Zhiqiang, Yu Wenjing, Yang Shihui. Research progress on relationship between forkhead box family and endometrial carcinoma [J]. International Medicine and Health Guidance News, 2022, 28(5): 699-701.
[10]	Liu Yu, Xu Jianying, Deng Lili, Guan Lijuan, Li Jianji, Lin Jingxia, Wu Qiaomei, Yang Liming. Experience of construction and nursing management of transitional wards under emergency situation in epidemic closed and controlled areas in Guangzhou [J]. International Medicine and Health Guidance News, 2022, 28(4): 516-519.
[11]	Wang Minxia, Liu Yang, Yu Hanfeng. Effect of TCRP combined with leuprorelin on levels of sex hormones and postoperative recurrence in patients with endometrial polyps [J]. International Medicine and Health Guidance News, 2022, 28(3): 399-402.
[12]	Xu Ruihua. Efficacy of infrared physiotherapy combined with external application of Glauber's salt on postoperative gastrointestinal dysfunction after surgery for acute appendicitis [J]. International Medicine and Health Guidance News, 2022, 28(3): 429-434.
[13]	Ren Junhua, Li Yanhua, Li Qunzhi, Liu Qin, Tang Zhijun. Effect of triple therapy of traditional Chinese medicine combined with enhanced recovery after surgery on gastrointestinal function recovery of patients with after laparoscopic colorectal cancer surgery [J]. International Medicine and Health Guidance News, 2022, 28(1): 86-89.