文献詳細
文献概要
特集 第64回日本臨床眼科学会講演集(5) 特別講演
糖尿病網膜症診療の戦略
著者: 山下英俊1
所属機関: 1山形大学医学部眼科学
ページ範囲:P.1027 - P.1041
文献購入ページに移動 糖尿病患者は世界中で急速に増加しており,厚生労働省によると,糖尿病が強く疑われる人は2006年で820万人に達している。2005年の調査では,糖尿病網膜症は日本人の後天性視覚障害の第2位を占め,視力障害者の約2割を占めていた。疫学研究の積み重ねから,失明を防ぐのみならず生涯にわたる良好な視力を保持するためには,糖尿病網膜症の早期発見,早期治療による発症予防(一次予防),重症化の予防(二次予防)の進歩が重要であることが明らかとなった。また,糖尿病網膜症は,心疾患・脳血管疾患などの大血管症の独立した危険因子であることも判明してきた。われわれ眼科医は,糖尿病網膜症の診療戦略のなかで,重要な機能を発揮することが期待されている。
参考文献
1)Wild S, Roglic G, Green A et al:Global Prevalence of Diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care 27:1047-1053, 2004
2)中江公裕・増田寛次郎・妹尾 正・他:わが国における視覚障害の現状.厚生労働省難治性疾患克服研究事業.網脈絡膜・視神経萎縮症に関する研究班.平成17年度研究報告書.263-267,2006
3)Alberti G, Zimmet P, Shaw J et al:The International Diabetes Federation Consensus Workshop, Type 2 Diabetes in the Young:The Evolving Epidemic. Diabetes Care 27:1798-1811, 2004
4)Kato S, Takemori M, Kitano S et al:Retinopathy in older patients with diabetes mellitus. Diabetes Res Clin Pract 58:187-192, 2002
5)Tominaga M, Eguchi H, Manaka H et al:Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 22:920-924, 1999
6)Kawasaki R, Tielsch JM, Wang JJ et al:The metabolic syndrome and retinal microvascular signs in a Japanese population:The Funagata study. Br J Ophthalmol 92:161-166, 2008
7)清野 裕:糖尿病の新しい診断基準.糖尿病レクチャー 1:414-418,2010
8)富永真琴:糖尿病診断基準と細小血管障害および大血管障害.あたらしい眼科 18:563-569,2001
9)Ito C, Maeda R, Ishida S et al:Correlation among fasting glucose, two-hour plasma glucose levels in OGTT and HbA1c. Diabetes Res Clin Pract 50:225-230, 2000
10)伊藤千賀子:糖尿病の新しい診断基準.糖尿病レクチャー 1:419-424,2010
11)Miyazaki M, Kubo M, Kiyohara Y et al:Comparison of diagnostic methods for diabetes mellitus based on prevalence of retinopathy in a Japanese population:the Hisayama Study. Diabetologia 47:1411-1415, 2004
12)安田美穂:糖尿病網膜症一次予防のエビデンス―久山町研究から.あたらしい眼科 24:1287-1290,2007
13)山本禎子・山下英俊:糖尿病網膜症.眼科 48:911-921,2006
14)Chew EY, Ferris FL Ⅲ, Csaky KG et al:The long-term effects of laser photocoagulation treatment in patients with diabetic retinopathy. The Early Treatment Diabetic Retinopathy Follow-up Study. Ophthalmology 110:1683-1689, 2003
15)Wilkinson CP, Ferris FL Ⅲ, Klein RE et al:Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 101:1677-1682, 2003
16)岸川秀樹・和気仲庸・荒川栄一・七里元亮:糖尿病の代謝コントロールと網膜症の発症進展阻止―DCCT/EDIC,Kumamoto Study,UKPDSの結果から.あたらしい眼科 24:1275-1280,2007
17)日本糖尿病学会:糖尿病治療の目標と指針.科学的根拠に基づく糖尿病診療ガイドライン2010.21-29,南江堂,東京,2010
18)曽根博仁・山田信博・山下英俊:糖尿病網膜症一次予防および二次予防のエビデンス.他の合併症との関連ならびにJDCS中間報告から.あたらしい眼科 24:1281-1285,2007
19)Sone H, Tanaka S, Iimuro S et al for the Japan Diabetes Complications Study Group:Long-term lifestyle intervention lowers the incidence of stroke in Japanese patients with type 2 diabetes:a nationwide multicentre randomised controlled trial(the Japan Diabetes Complications Study). Diabetologia DOI 10.1007/s00125-009-1622-2
20)Sasaki A, Horiuchi N, Hasegawa K et al:Development of diabetic retinopathy and its associated risk factors in type 2 diabetic patients in Osaka district, Japan:a long-term prospective study. Diabetes Res Clin Pract 10:257-263, 1990
21)大泉俊英・富永真琴:地域住民を対象とした疫学研究(2):日本人における糖尿病の実態―舟形町研究から.あたらしい眼科 21:435-439,2004
22)Kawasaki R, Wang JJ, Wong TY et al:Impaired glucose tolerance, but not impaired fasting glucose, is associated with retinopathy in Japanese population:The Funagata study. Diabetes, Obesity and Metabolism 10:514-522, 2008
23)Lachin JM, Genuth S, Nathan DM et al;DCCT/EDIC Research Group:Effect of glycemic exposure on the risk of microvascular complications in the diabetes control and complications trial-revisited. Diabetes 57:995-1001, 2008
24)Funatsu H, Yamashita H, Ohashi Y et al:Correlation between progression of diabetic retinopathy and blood glucose control. Jpn J Ophthalmol 35:306-316, 1991
25)United Kingdom Prospective Diabetes Study(UKPDS)Group:Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes(UKPDS 38). BMJ 317:703-713, 1998
26)The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group:Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 342:381-389, 2000
27)中野早紀子・山下英俊:糖尿病網膜症の成因と病態.カレントテラピー 26:572-576,2008
28)Funatsu H, Yamashita H, Ikeda T et al:Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology 110:1690-1696, 2003
29)Martidis A, Duker JS, Greenberg PB et al:Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 109:920-927, 2002
30)Yilmaz T, Weaver CD, Gallagher MJ et al:Intravitreal triamcinolone acetonide injection for treatment of refractory diabetic macular edema. Ophthalmology 116:902-913, 2009
31)Schindler RH, Chandler D, Thresher R et al:The clearance of intravitreal triamcinolone acetonide. Am J Ophthalmol 93:415-417, 1982
32)Tajika T, Waki M, Tsuzuki M et al:Pharmacokinetic features of difluprednate ophthalmic emulsion in rabbits as determined by glucocorticoid receptor-binding bioassay. J Ocul Pharmacol Ther, 2010 Dec 23[Epub ahead of print]
33)Nakano S, Yamamoto T, Kirii E et al:Steroid eye drop treatment(difluprednate ophthalmic emulsion)is effective in reducing refractory diabetic macular edema. Graefe's Arch Clin Exp Ophthalmol 248:763-778, 2010
34)Nakano Goto S, Yamamoto T, Kirii E et al:Treatment of diffuse diabetic macular oedema using steroid eye drops. Acta Ophthalmol, 2011 Jan 14. doi:10.1111/j. 1755-3768.2010.02066. x.[Epub ahead of print].
35)Aiello LP, Avery RL, Arrigg PG et al:Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331:1519-1520, 1994
36)Funatsu H, Yamashita H, Noma H et al:Outcome of vitreous surgery and the balance between vascular endothelial growth factor and endostatin. Invest Ophthalmol Vis Sci 44:1042-1047, 2003
37)Cunningham ET Jr, Adamis AP, Altaweel M et al:A phase Ⅱ randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology 112:1747-1757, 2005
38)安川 力:加齢黄斑変性:新しい薬物療法の可能性.あたらしい眼科 24:303-315,2007
39)Kook D, Wolf A, Kreutzer T et al:Long-term effect of intravitreal bevacizumab(avastin)in patients with chronic diffuse diabetic macular edema. Retina 28:1053-1060, 2008
40)Diabetic Retinopahty Clinical Research Network:A phase 2 randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology 114:1860-1867, 2007
41)Micaelides M, Kaines A, Hamilton RD et al:A prospective randomized trial of intravitreal bavacizumab or laser therapy in the management of diabetic macular edema(BOLT study)12-month data:report 2. Ophthalmology 117:1078-1086, 2010
42)Diabetic Retinopathy Clinical Research Network:Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology 117:1064-1077, 2010
43)石田 晋:糖尿病網膜症.黄斑症の分子病態:血管症の特性から.あたらしい眼科 27:1185-1193,2010
44)Chaturvedi N, Sjolie AK, Stephenson JM et al:Effects of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus. Lancet 351:28-31, 1998
45)Chaturvedi N, Porta M, Klein R et al:Effect of candesartan on prevention(DIRECT-Prevent 1)and progression(DIRECT-Protect 1)of retinopathy in type 1 diabetes:randomized, placebo-controlled trials. Lancet 372:1394-1402, 2008
46)Keech AC, Mitchell P, Summanen PA et al for the FIELD study investigator:Effect of fenofibrate on the need for laser treatment for diabetic retinopathy(FIELD study):a randomised controlled trial. Lancet 370:1687-1697, 2007
47)The ACCORD Study Group and ACCORD Eye Study Group:Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med 363:233-244, 2010
48)本間 慶・川崎 良:糖尿病網膜症の疫学:糖尿病網膜症と大血管症.あたらしい眼科 27:1169-1174,2010
49)Grammas P, Riden M:Retinal endothelial cells are more susceptible to oxidative stress and increased permeability than brain-derived endothelial cells. Microvascular Research 65:18-23, 2003
50)Hogan MJ, Feeney L:The ultrastructure of the retinal blood vessels:Ⅰ. The large vessels. J Ultrastruct Res 9:10-28, 1963
51)Hogan MJ, Feeney L:The ultrastructure of the retinal vessels:Ⅱ. The small vessels. J Ultrastruct Res 9:29-46, 1963
52)Goldberg RB:Cytokine and cytokine-like inflammation markers, endothelial dysfunction, and imbalanced coagulation in development of diabetes and its complications. J Clin Endocrinol Metab 94:3171-3182, 2009
53)Reaven PD, Emanuele N, Moritz T et al:Proliferative diabetic retinopathy in type 2 diabetes is related to coronary artery calcium in the Veterans Affairs Diabetes Trial(VADT). Diabetes Care 31:952-957, 2008
54)Klein R, Marino EK, Kuller LH et al:The relation of atherosclerotic cardiovascular disease to retinopathy in people with diabetes in the Cardiovascular Health Study. Br J Ophthalmol 86:84-90, 2002
55)Klein R, Sharrett AR, Klein BE et al:The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes:the atherosclerosis risk in communities study. Ophthalmology 109:1225-1234, 2002
56)Kawasaki R, Cheung N, Islam AFM et al:Diabetic retinopathy and markers of subclinical cardiovascular disease:the multi-ethnic study of atherosclerosis. Ophthalmology, 2010(In Press.)
57)Fuller JH, Stevens LK, Wang SL:Risk factors for cardiovascular mortality and morbidity:the WHO Mutinational Study of Vascular Disease in Diabetes. Diabetologia 44(Suppl 2):S54-S64, 2001
58)Cheung N, Rogers S, Couper DJ et al:Is diabetic retinopathy an independent risk factor for ischemic stroke? Stroke 38:398-401, 2007
59)Klein R, Klein BEK, Moss SE:Epidemiology of proliferative diabetic retinopathy. Diabetes Care 15:1875-1891, 1992
60)Wong TY, Klein R, Sharrett AR et al:Cerebral white matter lesions, retinopathy, and incident clinical stroke. JAMA 288:67-74, 2002
61)Hiller R, Sperduto RD, Podgor MJ et al:Diabetic retinopathy and cardiovascular disease in type Ⅱ diabetics. The Framingham Heart Study and the Framingham Eye Study. Am J Epidemiol 128:402-409, 1988
62)Cheung N, Wang JJ, Klein R et al:Diabetic retinopathy and the risk of coronary heart disease:the Atherosclerosis Risk in Communities Study. Diabetes Care 30:1742-1746, 2007
63)Cheung N, Wang JJ, Rogers SL et al:Diabetic retinopathy and risk of heart failure. J Am Coll Cardiol 51:1573-1578, 2008
64)Juutilainen A, Lehto S, Ronnemaa T et al:Retinopathy predicts cardiovascular mortality in type 2 diabetic men and women. Diabetes Care 30:292-299, 2007
65)Miettinen H, Haffner SM, Lehto S et al:Retinopathy predicts coronary heart disease events in NIDDM patients. Diabetes Care 19:1445-1448, 1996
66)Targher G, Bertolini L, Zenari L et al:Diabetic retinopathy is associated with an increased incidence of cardiovascular events in Type 2 diabetic patients. Diabet Med 25:45-50, 2008
67)Tong PC, Kong AP, So WY et al:Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with type 2 diabetes mellitus. Diabet Med 24:741-746, 2007
68)大野貴之・高本眞一:糖尿病網膜症患者に対する冠動脈疾患の診断と治療.日本の眼科 81:1012-1015,2010
69)Klein R, Klein BE, Moss SE et al:Association of ocular disease and mortality in a diabetic population. Arch Ophthalmol 117:1487-1495, 1999
70)Cusick M, Meleth AD, Agron E et al:Associations of mortality and diabetes complications in patients with type 1 and type 2 diabetes:early treatment diabetic retinopathy study report no. 27. Diabetes Care 28:617-625, 2005
71)Hovind P, Tarnow L, Rossing K et al:Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes. Diabetes Care 26:1258-1264, 2003
72)Tanabe Y, Kawasaki R, Wang JJ et al:Retinal arteriolar narrowing predicts 5-year risk of hypertension in Japanese people:the Funagata study. Microcirculation 17:94-102, 2010
73)斉藤公子・川崎 良:眼底検診と全身疾患.日本の眼科 81:101-104,2010
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