目的：利用光学相干断层扫描血管造影技术观察病理性近视脉络膜新生血管抗VEGF治疗期间的变化，探讨其在监测抗VEGF治疗过程的意义。

方法：本研究纳入临床确诊病理性近视脉络膜新生血管患者30例30眼。对患眼行玻璃体腔注射10mg/mL雷珠单抗0.05mL，治疗后每月随访病情，随访时间为6mo，每次随访均行最佳矫正视力(BCVA)、眼压、裂隙灯、前置镜眼底检查、OCTA检查。比较治疗前、治疗后1、3、6mo患者BCVA及黄斑中心视网膜厚度(CMT)。

结果：所有患者平均玻璃体腔注射1.70±0.65次。治疗前平均最佳矫正视力(LogMAR)为0.96±0.17，治疗后1、3、6mo视力分别提高了0.23±0.09、0.34±0.07、0.38±0.11，差异均有统计学意义(t=5.461、8.191、8.894，P<0.05)。治疗前平均CMT为281.07±13.72μm，治疗后1、3、6mo分别下降了19.73±9.02、37.62±15.41、46.15±25.16μm，差异均有统计学意义(t=12.007、13.360、9.531，P<0.05)。注射后OCTA显示CNV血管网直径缩小，密度降低。

结论：玻璃体腔注射雷珠单抗治疗病理性近视脉络膜新生血管疗效显著、安全性高； OCTA能无创、快速获得视网膜和脉络膜血管图像，为诊断病理性近视脉络膜新生血管和监控其治疗效果提供有力工具。

METHODS: The study enrolled 30 patients(30 eyes)diagnosed with myopic choroidal neovascularization. All affected eyes were treated with intravitreal ranibizumab 0.05mL(10mg/mL). Best corrected visual acuity(BCVA), non-contact tonometer, ophthalmoscope, fundus fluorescein angiograph(FFA)and OCTA were evaluated monthly until 6mo. The changes of BCVA and central macular thickness(CMT)were compared at 1, 3 and 6mo after treatment.

RESULTS: All patients received an average of 1.70±0.65 injections. BCVA was 0.96±0.17(LogMAR)before therapy, and BCVA 1, 3 and 6mo after treatment respectively improved by 0.23±0.09, 0.34±0.07, 0.38±0.11. The differences were significant(t=5.461, 8.191, 8.894; P<0.05). Mean CMT decreased form 281.07±13.72μm to 261.33±13.13μm, 243.47±16.65μm, 234.73±17.52μm respectively 1, 3 and 6mo after treatment, showing significant differences(t=12.007, 13.360, 9.531; P<0.05). OCTA revealed a progressively smaller vascular lesion and reduction in capillary density.

CONCLUSION: Intravitreal ranibizumab for CNV secondary to pathologic myopia is effective and safe; OCTA is a noninvasive and time-saving new technology, and it also is a promising tool for clinicians to make preliminary diagnosis and assess treatment efficacy in the follow-up visits.