摘要《我国糖尿病视网膜病变临床诊疗指南（2022年）——基于循证医学修订》是基于最近的临床试验提供的数据，并采用证据评价与推荐意见分级、制定和评价（Grading of Recommendations, Assessment, Development and Evaluation）的证据质量和推荐意见强度的评价方法制定的。主要的更新点围绕为什么糖尿病黄斑水肿（DME）的分型不断变化；对于累及黄斑中心凹的DME （CI-DME）但伴有较好视力者，何时能启动抗血管内皮生长因子（VEGF）药物治疗；对于临床有意义的黄斑水肿即使视力较好者，也能进行局部激光光凝；CI-DME的临床治疗路径从激光光凝调整为首先抗VEGF药物治疗；对于非增生型糖尿病视网膜病变（DR）患者，抗VEGF药物加载剂量从3针推荐为4~ 5针；对于严重的有视力损伤的非增生型DR和不合并玻璃体积血及视网膜牵拉的增生型DR患者，相较于全视网膜激光光凝（PRP），有条件可以考虑先行抗VEGF药物治疗（弱推荐），PRP始终是治疗进行性发展的无灌注区的金标准；光相干断层扫描、广角光相干断层扫描血管成像、广角荧光素眼底血管造影等DR评估设备的飞速发展，对DR病变程度、治疗反应和预后提供了影像学生物学标志。我们相信这一版指南将推动我国DR的诊疗进入新的高度。

abstractsEvidence-based guidelines for diagnosis and treatment of diabetic retinopathy in China (2022) is based on evidences in recent clinical trials and a system of Grading of Recommendations, Assessment, Development and Evaluation of evidence quality and strength of recommendations. The main key points around why the diabetic macular edema (DME) changes the classification, what thresholds for initiating anti-vascular endothelial growth factor (VEGF) drug therapy; eyes with center-involved DME (CI-DME) and good vision for clinical significant macular edema still treated by focal laser even with good vision, the clinical pathway for CI-DME changes first-line treatment from laser to anti-VEGF, loading dose of anti-VEGF for CI-DME in non-proliferative diabetic retinopathy (DR) from 3 injections up to 4-5 injections is recommended; severe non-proliferative DR and proliferative DR with vision impairment but without hemorrhages and retinal traction could be considered first treatment of anti-VEGF comparing to initiate pan-retinal photocoagulation (PRP) (weakly recommended), PRP is still gold-standard for progressive non-perfusion area of retina. With the rapid development of DR evaluation devices such as optical coherence tomography, wide-angle optical coherence tomography angiography and wide-angle fluorescein fundus angiography, imaging biomarkers have been provided for the degree of DR lesion, treatment response and prognosis. It is believed that the clinical practice will be promoted a new height by the 2022 edition of Chinese DR guideline.