目的：探讨玻璃体腔注射雷珠单抗联合视网膜光凝(523激光)治疗视网膜中央静脉阻塞(central retinal vein occlusion，CRVO)伴视网膜新生血管及黄斑水肿的临床疗效。

方法：选取2016-01/2017-01于我院治疗的CRVO伴视网膜新生血管及黄斑水肿患者70例70眼，按照治疗方式不同分为两组，将采用玻璃体腔注射雷珠单抗联合523激光治疗的35例35眼患者设为观察组，仅采用523激光治疗的35例35眼患者设为对照组，对其病历资料进行回顾性分析。观察治疗前及治疗3mo后最佳矫正视力以及术后眼压变化情况，并通过光学相干断层扫描(optical coherence tomography，OCT)以及眼底荧光血管造影(fundus fluorescein angiography，FFA)测量中央视网膜厚度(central retinal thickness，CRT)，评价治疗前后视网膜病变进展情况，跟踪随访观察治疗后并发症发生情况。

结果：治疗3mo后两组患者最佳矫正视力保持不变、提高1行、提高2行、提高3行及以上者差异均具有统计学意义(P<0.05)； 两组患者治疗前后眼压比较差异无统计学意义(P>0.05)，治疗后组间比较差异无统计学意义(P>0.05)； 两组治疗前后CRT比较差异有统计学意义(P<0.01)，治疗后观察组CRT显著低于对照组，差异具有统计学意义(P<0.01)； 治疗3mo后OCT、FFA检查黄斑水肿消退25眼(71%)，显著高于对照组19眼(54%)，差异具有统计学意义(χ²=6.292，P=0.012)，治疗后1mo两组患者新生血管明显减退，观察组治疗后1mo复发2眼(6%)，对照组复发10眼(29%)，观察组治疗后3mo复发3眼(9%)，对照组复发19眼(54%)，差异具有统计学意义(P<0.05)。

结论：玻璃体腔注射雷珠单抗联合523激光治疗CRVO伴视网膜新生血管及黄斑水肿患者，能提高患者视力，促进视网膜渗出、出血的吸收。

METHODS: The subjects of this study were 70 patients(70 eyes)with CRVO and retinal neovascularization and macular edema treated in our hospital from January 2016 to January 2017. There were 35 patients(35 eyes)treated with intravitreal injection of ranibizumab combined 523 laser and enrolled in the observation group; 35 patients(35 eyes)treated with 523 laser alone and selected as the control group. The medical records were retrospectively analyzed. The best corrected visual acuity and intraocular pressure(IOP)were observed before treatment and 3mo after treatment. The central retinal thickness(CRT)was measured by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)to evaluate the changes of retinal lesions progress and follow-up observation of the incidence of complications after treatment.

RESULTS: After 3mo of treatment, the best corrected visual acuity remained unchanged in both groups. There was no significant difference between the two groups in best corrected visual acuity improved by 1 lines, 2 lines, 3 lines and above(P<0.05). There was no significant difference in intraocular pressure before and after operation, and in those between the two groups(P>0.05). There was significant difference of CRT between the two groups, before and after treatment(P<0.01); postoperatively CRT of observation group was significantly lower than that of the control group, the difference was statistically significant(P<0.01). There were 25 cases(71%)of macular edema subsided detected by OCT and FFA 3mo after operation, which was significantly higher than that of the control group(19 eyes, 54%), the difference was statistically significant(χ²=6.292, P=0.012). Neovascularization significantly relieved in both groups at 1mo after the operation. In the observation group, 2 cases recurred 1mo after operation, the recurrence rate was 6%; 10 cases recurred in the control group, and the recurrence rate was 29%. In the observation group, there were 3 cases of recurrence 3mo after operation, the recurrence rate was 9%, the recurrence of the control group was 19 cases, the recurrence rate was 54%, the difference was statistically significant(P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab combined with 523 laser can significantly improve visual acuity in patients with CRVO, which can effectively prevent the formation of retinal neovascularization and accelerate the exudation bleeding and edema absorption.