[Pathophysiology and therapeutic progress of diabetic macular edema].

Diabetic macular edema (DME) is the leading cause of vision loss in diabetics. The destruction of blood retinal barrier is the primary pathological feature. At present, a large number of animal experiments and clinical studies show that DME not only has abnormal vascular structure, but also is an inflammatory disease. A variety of inflammatory media and chemokine are involved in the process of DME. With the extensive clinical application of anti-vascular endothelial growth factor (VEGF), the treatment of DME got a revolutionary breakthrough. However, unlike proliferative diabetic retinopathy (PDR), DME patients response intensively to anti-VEGF agents and couldn't resolve completely despite of multiple injections. Therefore, in addition to VEGF, other possible therapeutic targets and clinical trials of new drugs are also widely carried out. This article reviews the therapeutic process of DME. (Chin J Ophthalmol, 2018, 54: 625-630).糖尿病黄斑水肿（DME）是导致糖尿病患者视力下降的主要原因。血-视网膜屏障破坏是其最主要的病理特点。目前大量动物试验和临床研究结果证实，DME不仅存在血管构型的异常，同时也是一种炎性反应性疾病。多种炎性介质、趋化因子等参与了DME的发生和发展过程。随着抗血管内皮生长因子（VEGF）药物在临床广泛应用，DME的治疗获得革命性突破。本文在回顾激光光凝、手术和药物治疗DME的基础上，从抗VEGF治疗、多生长因子抑制剂治疗、抗炎治疗和干细胞治疗4个方面重点总结和分析DME治疗的最新研究进展，以期为临床开展相关研究提供参考。（中华眼科杂志，2018，54：625-630）.