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Critical appraisal of ranibizumab in the treatment of diabetic macular edema

机译：雷珠单抗治疗糖尿病性黄斑水肿的关键评估

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Abstract: Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME). The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF) appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab) have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea.
机译：摘要：糖尿病性视网膜病是工业化国家工作年龄人群失明的主要原因，大部分视力下降是由糖尿病性黄斑水肿（DME）引起的。 DME的形成取决于几种生长因子和炎症介质的作用，但血管内皮生长因子（VEGF）对于打破血视网膜屏障和促进黄斑水肿的积累似乎至关重要。激光光凝已经成为三十年的护理标准，尽管它可以稳定视力，但是治疗后视力的显着提高并不常见。几种VEGF抑制剂（培加他尼，阿柏西普和兰尼单抗）已被初步开发和测试，用于治疗与年龄相关的黄斑变性，随后用于DME。在DME的I，II和III期试验中，兰尼单抗已被证明优于黄斑激光光凝术和眼内注射醋酸曲安奈德，以改善视力和干燥黄斑。结果，兰尼单抗是唯一获得美国食品和药物管理局批准用于DME治疗的抗VEGF药物。现在，大多数专家认为玻璃体内抗VEGF治疗是涉及中央凹的DME的标准护理。

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