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4 展 望
尽管在治疗DME方面已有巨大进展，但还需有效、副作用更小的治疗措施，目前的研究重点在于寻求破坏性更小的预防和治疗DME的方法，同时考虑患者的健康质量。
阈下视网膜光凝是现在正在研究的一种激光光凝的替代方法。即微脉冲810?nm半导体激光阈下视网膜光凝，将一个曝光时间分为多个短负荷时间和长关闭时间的微脉冲，热量限制在RPE层回避视网膜感觉神经层，对视网膜的损伤大大降低，疗效显著。对阈下视网膜光凝进一步的研究，将可能使其成为弥漫性黄斑水肿的首选治疗方法。
PKC抑制剂能够在动物模型中抑制VEGF及糖尿病诱导的血管通透性增加，目前有两个主要针对VEGF抗体的研究热点，即选择性VEGF165的抗体Pegaptanib（Macugen）和VEGFA Fab片段的抗体Ranibizumab（Lucentis）。临床研究表明，Ranibizumab可以阻止血管渗漏和新生血管的形成。Dal等［32］报道，玻璃体腔注射不同剂量的Ranibizumab（0.3或0.5?mg）,观察24个月,结果发现患者耐受性良好,3个月后患者的视力均有不同程度的提高,黄斑中心凹厚度均有下降,其中高剂量组下降明显，二者代表了未来药物研发的一个方向。
口服碳酸酐酶抑制剂治疗黄斑囊样水肿，可以轻度增加视力［33］。从临床角度来看对于不同病变采取不同的治疗方案，掌握治疗时机，对保护黄斑功能尤为重要。
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