背景:在所有患有糖尿病性视网膜病变(DR)的眼睛中,视网膜缺血或多或少地存在。尽管如此,我们对其致病机制的理解,危险因素,以及其他特征的视网膜缺血在DR是非常有限的。迄今为止,缺血性视网膜血管重建没有治疗方法。
方法:回顾强调DR中视网膜缺血主题的现有知识的文献,重要的观察,以及需要研究的潜在差距。
结果:很少有临床研究,主要是横截面,在DR中特别评估了视网膜缺血。个体差异对其自然过程和后果的影响,包括其主要并发症的发展,即糖尿病性黄斑缺血和增生性糖尿病性视网膜病变,没有被调查。在原地,周围,视网膜缺血对视网膜功能和结构的距离影响及其随时间的变化也有待阐明。治疗,以防止视网膜缺血的发展和,重要的是,一旦毛细血管脱落,实现视网膜再灌注,非常需要,还有待开发。
结论:糖尿病患者视网膜缺血的研究应优先考虑挽救视力。
BACKGROUND: Retinal ischaemia is present to a greater or lesser extent in all eyes with diabetic retinopathy (DR). Nonetheless, our understanding of its pathogenic mechanisms, risk factors, as well as other characteristics of retinal ischaemia in DR is very limited. To date, there is no treatment to revascularise ischaemic retina.
METHODS: Review of the literature highlighting the current knowledge on the topic of retinal ischaemia in DR, important observations made, and underlying gaps for which research is needed.
RESULTS: A very scarce number of clinical studies, mostly cross-sectional, have evaluated specifically retinal ischaemia in DR. Interindividual variability on its natural course and consequences, including the development of its major complications, namely diabetic macular ischaemia and proliferative diabetic retinopathy, have not been investigated. The in situ, surrounding, and distance effect of retinal ischaemia on retinal function and structure and its change over time remains also to be elucidated. Treatments to prevent the development of retinal ischaemia and, importantly, to achieve retinal reperfusion once capillary drop out has ensued, are very much needed and remain to be developed.
CONCLUSIONS: Research into retinal ischaemia in diabetes should be a priority to save sight.