endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-4-08endofocus-189Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWРоль VEGF-направленных препаратов в терапии диабетической ретинопатии и макулярного отека: что нужно знать эндокринологуThe role of VEGF-directed drugs in the treatment of diabetic retinopathy and macular edema: What an endocrinologist needs to knowhttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

Ушанова Фатима Омариевна – к. м. н., доцент кафедры эндокринологии ИКМ

г. Москва

Fatima O. Ushanova – C. Sci. (Med.), Associate Professor of the Department of Endocrinology, Institute of Clinical Medicine

Moscow

fati_2526@mail.ruhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна – д.м.н., профессор, заведующий кафедрой эндокринологии ИКМ

г. Москва

Tatiana Yu. Demidova – D. Sci. (Med.), Prof., Head of the Department of Endocrinology, Institute of Clinical Medicine

Moscow

t.y.demidova@gmail.comhttps://orcid.org/0000-0002-6891-1711НадыбинаМ. Н.NadybinaM. N.

Надыбина Маргарита Николаевна – аспирант кафедры эндокринологии ИКМ

г. Москва

Margarita N. Nadybina – postgraduate student of the Department of Endocrinology, Institute of Clinical Medicine

Moscow

mita0098@gmail.comhttps://orcid.org/0000-0002-1385-0245ИзмайловаМ. Я.IzmaylovaM. Ya.

Измайлова Марьям Ярагиевна – ассистент кафедры эндокринологии ИКМ

г. Москва

Maryam Ya. Izmailova – assistant at the Department of endocrinology, Institute of Clinical Medicine

Moscow

maremizm@gmail.comФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава России (Пироговский университет)Pirogov Russian National Research Medical University20252712202564Нейроэндокринология6370Copyright © Ушанова Ф.О., Демидова Т.Ю., Надыбина М.Н., Измайлова М.Я., 20252025Ушанова Ф.О., Демидова Т.Ю., Надыбина М.Н., Измайлова М.Я.Ushanova F.O., Demidova T.Y., Nadybina M.N., Izmaylova M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/189

Диабетическая ретинопатия (ДР) и диабетический макулярный отек (ДМО) – наиболее распространенные хронические микроангиопатические осложнения сахарного диабета (СД), борьба с которыми является актуальной проблемой современного здравоохранения. ДР – пятая по распространенности причина слепоты во всем мире и главная причина снижения зрения у пациентов с СД. Поздняя пролиферативная стадия развития ДР характеризуется повышенной выработкой фактора роста эндотелия сосудов (VEGF), который выступает основным патогенетическим фактором прогрессии данного заболевания. Современные представления о механизмах развития ДР и роли VEGF позволяют выделить несколько основных направлений терапии. Так, основным методом лечения ДР служит лазерная коагуляция сетчатки (ЛКС), а наиболее эффективным методом лечения ДМО считается комбинация ЛКС и интравитреального введения анти-VEGF-препаратов. В современной диабетологии и офтальмологии интравитреальная таргетная анти-VEGF-терапия радикально изменила исход ДР и ДМО благодаря своему антиангиогенному и противоотечному действию. В настоящее время наиболее эффективными анти-VEGF-препаратами признаны ранибизумаб, бролуцизумаб и афлиберцепт. С появлением этих препаратов существенно улучшился прогноз пациентов за счет достижения лучшей остроты зрения, замедления прогрессии ДР и профилактики угрожающих зрению осложнений. В этом обзоре представлена актуальная информация о роли VEGF в патогенезе ДР, а также о современных стратегиях ведения пациентов с ДР и ДМО.

Diabetic retinopathy (DR) and diabetic macular edema (DME) are the most common microangiopathic complications of diabetes mellitus, that represent one of the most relevant problems of modern healthcare. DR is the fifth most common cause of blindness worldwide and the main cause of vision loss in patients with diabetes. Proliferative DR (PDR) is the last stage of this complex retinal disease and is characterized by abnormal production of vascular endothelial growth factor (VEGF), which is one of the most important pathogenic factors of DR. based on the current data on DR development and the role of VEGF, there can be identified several therapeutic strategies. Panretinal photocoagulation (PRP) is the standard treatment for proliferative diabetic retinopathy. In addition, combination of PRP and intravitreal administration of antiVEGF drugs is considered the most effective method for the management of DME. Modern strategies in diabetology and ophthalmology include anti-VEGF therapy that has radically changed the outcome of DR due to its antiangiogenic activity. Currently, the most effective anti-VEGF drugs are ranibizumab, brolucizumab and aflibercept. They have significantly changed the prognosis of patients, due to achieving better visual acuity and preventing the progression of DR and vision-threatening complications. In the present review, we have provided up-to-date information on the role of VEGF in the pathogenesis of DR, as well as on the current management strategies of DR and DMO. 

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The authors declare that there are no conflicts of interest present.