糖尿病網膜症の診断と治療の進歩

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（特に重要な文献については，番号をゴシック体で表記している．）

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

Toshio HISATOMI

Department of Ophthalmology, Fukuoka University Chikushi Hospital

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.

Keywords：Diabetic retinopathy, retinal ischemia, vascular permeability, Minimally Invasive

Vitrectomy Surgery, Brilliant Blue G

著者プロフィール

久冨 智朗（ひさとみ としお）

福岡大学筑紫病院 診療部長・准教授（眼科） 医学博士

◆略歴 1971 年山口県に生まれる．1996 年九州大学医学部卒業．

2003 年同大大学院医学研究科博士課程終了．2005 年ハーバード大学マサチューセッツ眼

科耳鼻科病院リサーチフェロー．2018 年九州大学眼病態イメージング講座准教授．2019

年より現職．

◆研究テーマ 網膜硝子体疾患の病態治療研究，細胞死の分子機構研究，新規硝子体白内障手術補

助剤の開発．電子顕微鏡，病理所見から病態を理解し，手術療法の発展や，更なる治療法改

善へのトランスレーショナルリサーチを進めています．

◆趣味 天体観測，DIY，釣り，テニス

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