无创治疗新策略：水凝胶在糖尿病视网膜病变中的应用进展

Non-Invasive Treatment Strategy: Advances in Hydrogel Application for Diabetic Retinopathy

摘要: 糖尿病视网膜病变(diabetic retinopathy, DR)传统治疗存在创伤大、依从性差等局限。本文系统检索PubMed、Web of Science、CNKI等数据库2019~2024年文献，综述水凝胶递药系统的临床转化价值。水凝胶可通过原位凝胶滴眼液、接触镜及结膜下注射实现无创/微创给药，规避玻璃体腔注射并发症；壳聚糖、透明质酸等天然材料具有抑制NF-κB、调节巨噬细胞极化等内在抗炎活性，可保护血–视网膜屏障。已上市产品Ozurdex和Iluvien分别实现3~6个月和36个月长效缓释，III期临床显示视力改善率显著优于对照组。国内相关研究处于临床前阶段。水凝胶为DR长期管理提供新策略，规模化生产和个体化释药技术的突破将推动其更广泛的应用。

Abstract: Traditional treatments for diabetic retinopathy (DR) have limitations, including high invasiveness and poor patient compliance. This review systematically retrieved literature from databases such as PubMed, Web of Science, and CNKI from 2019 to 2024 and summarizes the clinical translational value of hydrogel drug delivery systems. Hydrogels enable non-invasive/minimally invasive drug delivery through in-situ gel eye drops, contact lenses, and subconjunctival injection, avoiding complications associated with intravitreal injection. Natural materials such as chitosan and hyaluronic acid possess intrinsic anti-inflammatory activities, including NF-κB inhibition and macrophage polarization regulation, protecting the blood-retinal barrier. Approved products Ozurdex and Iluvien achieve sustained release for 3~6 months and 36 months, respectively, with Phase III clinical trials demonstrating significantly better visual acuity improvement compared to control groups. Domestic research remains in the preclinical stage. Hydrogels provide new strategies for long-term DR management, but technical bottlenecks in scalable production and personalized drug release need to be addressed.