Surgery for diabetic macular edema

摘要

Diabetic macular edema is a significant source of visual deterioration in patients with diabetes mellitus. In the Wisconsin Epidemiologic Study of Diabetic Retin-opathy, the incidence of diabetic macular edema over a 10 year period ranged from 13.9% in adult onset patients not taking insulin, to 25.4% in adult onset patients receiving insulin.The cause of diabetic macular edema is usually from leakage of intraretinal fluid from microaneurysms and abnormal retinal capillaries.2 The pathogenesis of diabetic macular edema is likely multifactorial. Potential instigating factors include increased diastolic blood pressure, duration of diabetes, age at diagnosis, female sex, use of insulin, levels of glycosylated hemoglobin, amount of proteinuria, cardiac decompensation, more severe diabetic retinopathy, and previous panretinal photocoagulation.1'3 A combination of these factors presumably leads to a breakdown in the blood-retinal barrier causing macular edema.