方法：随机将74例86眼糖尿病性黄斑水肿引起视力下降的患者分成两组，即治疗组和对照组。治疗组43例48眼玻璃体腔注射Bevacizumab注射液1.25mg，3wk后进行局部或格栅样视网膜光凝。对照组31例38眼单纯玻璃体腔注射Bevacizumab注射液1.25mg，跟踪观察治疗前、治疗后3，6wk； 3mo两组视力情况与视网膜厚度的变化。

结果：两组视力比较，治疗前、治疗后3wk时无统计学意义，两组间治疗后6wk； 3mo比较差异有显著性。治疗组黄斑中心凹厚度在治疗前，治疗后3，6wk； 3mo分别为395.933±119.784，292.617±39.131，302.350±55.272，314.200±60.528μm。对照组治疗前，治疗后3，6wk； 3mo分别为398.734±111.764，301.217±34.231，312.120±53.170，395.145±108.687μm。两组在治疗前、治疗后3wk视网膜厚度无统计学意义，但在治疗后6wk和3mo时差异有统计学意义。

结论：玻璃体腔注射Bevacizumab后联合黄斑激光光凝治疗糖尿病性弥漫性黄斑水肿更有效，有利于视网膜光凝，并且能提高糖尿病性黄斑水肿患者的视力。

METHODS: Eighty-six eyes of 74 patients with diffuse DME were randomized into 2 groups. In laser group, 48 eyes were subjected to a macular Focal/grid laser photocoagulation 3 weeks after intravitreal injection of 1.25mg doses of Bevacizumab. In control group, 38 eyes underwent only intravitreal injection of 1.25mg doses of Bevacizumab. The changes of visual acuity and central macular thickness of all eyes in both groups preoperatively, 3 and 6 weeks, 3 months postoperatively were recorded.

RESULTS:There was no statistical significance on visual acuity before and 3 weeks after treatment, while the differences before and 6weeks and 3 months after treatment were significant. Central macular thicknesses were 395.933±119.784, 292.617±39.131, 302.350±55.272 and 314.200±60.528μm before, and 3,6 weeks, 3 months after injection, respectively in laser group. In control group, those were 398.734±111.764, 301.217±34.231, 312. 120±53.170 and 395.145±108.687μm, respectively. The 2-tailed T test revealed that visual acuity was not significantly different between two groups at baseline and 3 weeks after injection, but were significantly better in laser group at 6 weeks(P=0.02)and 3 months after treatment(P<0.001).

CONCLUSION: Intravitreal injection of Bevacizumab combined retinal photocoagulation is more effective to diffuse DME, benefits retinal photocoagulation and improves visual acuity of patients with diabetic macular edema.