视敏度:有高质量的证据表明,对于黄斑水肿累及黄斑中央的糖尿病患者,玻璃体内注射雷珠单抗可快速且持续提高患者视敏度。[59]Nguyen QD, Brown DM, Marcus DM, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012 Apr;119(4):789-801.http://www.aaojournal.org/article/S0161-6420%2811%2901242-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/22330964?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有高质量的证据表明,对于黄斑水肿累及黄斑中央的糖尿病患者,玻璃体内注射雷珠单抗可快速且持续提高患者视敏度。[59]Nguyen QD, Brown DM, Marcus DM, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012 Apr;119(4):789-801.http://www.aaojournal.org/article/S0161-6420%2811%2901242-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/22330964?tool=bestpractice.com
视敏度:有高质量的证据表明,对于黄斑水肿累及黄斑中央的糖尿病患者,玻璃体内注射阿柏西普 (aflibercept) 可快速且持续提高患者视敏度。[63]Heier JS, Korobelnik JF, Brown DM. et al. Intravitreal aflibercept for diabetic macular edema: 148-week results from the VISTA and VIVID studies. Ophthalmology. 2016 Nov;123(11):2376-85.http://www.ncbi.nlm.nih.gov/pubmed/27651226?tool=bestpractice.com[64]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. Lancet. 2017 Jun 3;389(10085):2193-203.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31193-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/28494920?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有高质量的证据表明,对于黄斑水肿累及黄斑中央的糖尿病患者,玻璃体内注射阿柏西普 (aflibercept) 可快速且持续提高患者视敏度。[63]Heier JS, Korobelnik JF, Brown DM. et al. Intravitreal aflibercept for diabetic macular edema: 148-week results from the VISTA and VIVID studies. Ophthalmology. 2016 Nov;123(11):2376-85.http://www.ncbi.nlm.nih.gov/pubmed/27651226?tool=bestpractice.com[64]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. Lancet. 2017 Jun 3;389(10085):2193-203.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31193-5/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/28494920?tool=bestpractice.com
视敏度:有高质量的证据表明,对于患有轻度至中度非增殖性糖尿病性视网膜病变和黄斑水肿的患者,黄斑激光治疗可减少其 2 至 3 年内的视力丧失。[65]Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985 Dec;103(12):1796-806.http://www.ncbi.nlm.nih.gov/pubmed/2866759?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有高质量的证据表明,对于患有轻度至中度非增殖性糖尿病性视网膜病变和黄斑水肿的患者,黄斑激光治疗可减少其 2 至 3 年内的视力丧失。[65]Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985 Dec;103(12):1796-806.http://www.ncbi.nlm.nih.gov/pubmed/2866759?tool=bestpractice.com
视敏度:有高质量的证据表明,对于患有中度至重度非增殖性糖尿病视网膜病变和黄斑水肿的患者,全视网膜光凝术可有效降低重度视力丧失的风险。[68]Patz A, Schatz H, Berkow JW, et al. Macular edema: an overlooked complication of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol. 1973 Jan-Feb;77(1):OP34-42.http://www.ncbi.nlm.nih.gov/pubmed/4738180?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有高质量的证据表明,对于患有中度至重度非增殖性糖尿病视网膜病变和黄斑水肿的患者,全视网膜光凝术可有效降低重度视力丧失的风险。[68]Patz A, Schatz H, Berkow JW, et al. Macular edema: an overlooked complication of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol. 1973 Jan-Feb;77(1):OP34-42.http://www.ncbi.nlm.nih.gov/pubmed/4738180?tool=bestpractice.com
视敏度:有高质量的证据表明,对于患有增殖性糖尿病视网膜病变的患者,全视网膜光凝术可在 3 至 5 年内有效降低重度视力丧失的风险。[70]Hercules BL, Gayed II, Lucas SB, et al. Peripheral retinal ablation in the treatment of proliferative diabetic retinopathy: a three-year interim report of a randomised, controlled study using the argon laser. Br J Ophthalmol. 1977 Sep;61(9):555-63.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1043048/pdf/brjopthal00237-0004.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/336079?tool=bestpractice.com[71]Ferris F. Early photocoagulation in patients with either type I or type II diabetes. Trans Am Ophthalmol Soc. 1996;94:505-37.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312110/pdf/taos00005-0523.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8981711?tool=bestpractice.com[47]Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS report number 8. Ophthalmology. 1981 Jul;88(7):583-600.http://www.ncbi.nlm.nih.gov/pubmed/7196564?tool=bestpractice.com[67]Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology. 1991 May;98(5 Suppl):766-85.http://www.ncbi.nlm.nih.gov/pubmed/2062512?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有高质量的证据表明,对于患有增殖性糖尿病视网膜病变的患者,全视网膜光凝术可在 3 至 5 年内有效降低重度视力丧失的风险。[70]Hercules BL, Gayed II, Lucas SB, et al. Peripheral retinal ablation in the treatment of proliferative diabetic retinopathy: a three-year interim report of a randomised, controlled study using the argon laser. Br J Ophthalmol. 1977 Sep;61(9):555-63.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1043048/pdf/brjopthal00237-0004.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/336079?tool=bestpractice.com[71]Ferris F. Early photocoagulation in patients with either type I or type II diabetes. Trans Am Ophthalmol Soc. 1996;94:505-37.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312110/pdf/taos00005-0523.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8981711?tool=bestpractice.com[47]Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS report number 8. Ophthalmology. 1981 Jul;88(7):583-600.http://www.ncbi.nlm.nih.gov/pubmed/7196564?tool=bestpractice.com[67]Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology. 1991 May;98(5 Suppl):766-85.http://www.ncbi.nlm.nih.gov/pubmed/2062512?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有中等质量证据表明,与延期玻璃体切除术相比,早期玻璃体切除术对于近期严重玻璃体出血(特别是对于 1 型糖尿病病程<20 年的患者)和重度增殖性糖尿病视网膜病变患者均有效。[74]Diabetic Retinopathy Vitrectomy Study Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial. Diabetic Retinopathy Vitrectomy Study report 5. Arch Ophthalmol. 1990 Jul;108(7):958-64.http://www.ncbi.nlm.nih.gov/pubmed/2196036?tool=bestpractice.com[61]Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized clinical trial. Diabetic Retinopathy Vitrectomy Study report 2. Arch Ophthalmol. 1985 Nov;103(11):1644-52.http://www.ncbi.nlm.nih.gov/pubmed/2865943?tool=bestpractice.com[62]Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial: Diabetic Retinopathy Vitrectomy Study report 3. Ophthalmology. 1988 Oct;95(10):1307-20.http://www.ncbi.nlm.nih.gov/pubmed/2465517?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
视敏度:有中等质量证据表明,与延期玻璃体切除术相比,早期玻璃体切除术对于近期严重玻璃体出血(特别是对于 1 型糖尿病病程<20 年的患者)和重度增殖性糖尿病视网膜病变患者均有效。[74]Diabetic Retinopathy Vitrectomy Study Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial. Diabetic Retinopathy Vitrectomy Study report 5. Arch Ophthalmol. 1990 Jul;108(7):958-64.http://www.ncbi.nlm.nih.gov/pubmed/2196036?tool=bestpractice.com[61]Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized clinical trial. Diabetic Retinopathy Vitrectomy Study report 2. Arch Ophthalmol. 1985 Nov;103(11):1644-52.http://www.ncbi.nlm.nih.gov/pubmed/2865943?tool=bestpractice.com[62]Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial: Diabetic Retinopathy Vitrectomy Study report 3. Ophthalmology. 1988 Oct;95(10):1307-20.http://www.ncbi.nlm.nih.gov/pubmed/2465517?tool=bestpractice.com