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已发表论文
糖尿病黄斑水肿的药物治疗：关于持久性和多靶点治疗的 2025 年更新
Authors Tao Y , Zhang Y , Xu W, Liu G, Liu H
Received 23 November 2025
Accepted for publication 25 January 2026
Published 3 February 2026 Volume 2026:20 583837
DOI https://doi.org/10.2147/DDDT.S583837
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Yunhan Tao,1,2 Yiteng Zhang,1,2 Wei Xu,1,2 Guina Liu,1,2 Hongtao Liu1,2
1Department of Ophthalmology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, People’s Republic of China
Correspondence: Hongtao Liu, Department of Ophthalmology, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, People’s Republic of China, Email hongtaoliu@scu.edu.cn
Abstract: Diabetic macular edema (DME) remains a leading cause of vision loss in the working-age population, yet its management is undergoing a fundamental paradigm shift from high-frequency anti-VEGF monotherapy toward more durable and multi-mechanism therapeutic strategies. This narrative review provides an up-to-date overview of the pharmacological landscape of DME as of 2025, synthesizing evidence from pivotal clinical trials, recent regulatory approvals, and available real-world outcomes. We examine the transition toward injection-sparing approaches and discuss the clinical rationale for targeting alternative biological pathways beyond VEGF inhibition, including angiopoietin-2 (eg, faricimab), the plasma kallikrein–kinin system, and tyrosine kinase–mediated signaling. Collectively, emerging evidence suggests that the future management of DME will be defined by a paradigm shift toward injection-sparing, multi-pathway therapeutic strategies, extending beyond short-term fluid suppression toward a more personalized, precision-medicine framework that prioritizes long-term durability, safety, and functional outcomes.
Keywords: diabetic macular edema, pharmacological treatment, anti-VEGF, corticosteroids, long-acting therapy, multi-target, gene therapy
1Department of Ophthalmology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, People’s Republic of China
Correspondence: Hongtao Liu, Department of Ophthalmology, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin South Road, Wuhou District, Chengdu, Sichuan, People’s Republic of China, Email hongtaoliu@scu.edu.cn
Abstract: Diabetic macular edema (DME) remains a leading cause of vision loss in the working-age population, yet its management is undergoing a fundamental paradigm shift from high-frequency anti-VEGF monotherapy toward more durable and multi-mechanism therapeutic strategies. This narrative review provides an up-to-date overview of the pharmacological landscape of DME as of 2025, synthesizing evidence from pivotal clinical trials, recent regulatory approvals, and available real-world outcomes. We examine the transition toward injection-sparing approaches and discuss the clinical rationale for targeting alternative biological pathways beyond VEGF inhibition, including angiopoietin-2 (eg, faricimab), the plasma kallikrein–kinin system, and tyrosine kinase–mediated signaling. Collectively, emerging evidence suggests that the future management of DME will be defined by a paradigm shift toward injection-sparing, multi-pathway therapeutic strategies, extending beyond short-term fluid suppression toward a more personalized, precision-medicine framework that prioritizes long-term durability, safety, and functional outcomes.
Keywords: diabetic macular edema, pharmacological treatment, anti-VEGF, corticosteroids, long-acting therapy, multi-target, gene therapy