糖尿病網膜症の診断と治療の進歩

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  • Advances in Diagnosis and Treatment of Diabetic Retinopathy
  • トウニョウビョウ モウマクショウ ノ シンダン ト チリョウ ノ シンポ

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Diabetic retinopathy is clinically important for diagnosis of diabetes mellitus so that diabetic retinopathy can be reliably detected by fundus examination with the blood glucose level indicating mdiabetic typen. Diabetic retinopathy has been the leading cause of adult blindness in Japan. In diabetic retinopathy, long-lasting hyperglycemia causes vascular endothelial damage, increased vascular permeability toward progression of retinopathy. According to the Davis classification that is frequently used clinically, the pathophysiology, diagnosis, and treatment of diabetic retinopathy were classified into simple retinopathy, preproliferative retinopathy, and proliferative retinopathy. Diabetic retinopathy causes pathological changes in the neuroretina, and degenerative atrophy of the macula causes irreversible visual impairment. Following extensive ischemia and increased permeability of the retina, it is thought that neuronal degeneration occurs, leading to degeneration and atrophy of retinal tissue, especially in the macula. With anti-VEGF treatment, macula edema has been improved in the short term, but the pathology and molecular mechanism of retinal degeneration remain unknown. In Japan, outcomes of diabetic retinopathy treatment have improved due to recent remarkable progression of Ophthalmic imaging techniques such as optical coherence tomography (OCT), Minimally Invasive Vitrectomy Surgery (MIVS), and membrane staining adjuvant such as Brilliant Blue G during ocular surgery.

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