目的：观察玻璃体腔内注射康柏西普联合多波长多点扫描激光全视网膜光凝(PRP)治疗早期PDR的临床效果。

方法：回顾性病例对照研究。选取我院眼科确诊为早期PDR的患者80例102眼，排除视网膜纤维增殖膜和玻璃体积血。A组(单纯PRP组)48例60眼，B组(康柏西普联合PRP组)32例42眼，激光治疗前3～5d玻璃体腔内注射康柏西普0.5mg。两组患者均分两次采用多波长多点扫描激光完成PRP治疗，间隔时间3～7d。3mo后根据FFA结果必要时补充激光。术后至少随访3mo，观察患者治疗效果和相关并发症、PRP术后3mo时BCVA，以及两组患者PRP术后1wk，1、3mo时黄斑中心视网膜厚度(CMT)变化。

结果：A组患者玻璃体积血、黄斑水肿或原黄斑水肿加重的发生率均高于B组(P<0.05)。术后3mo时，A组治疗总有效率为73.3%，B组总有效率为90.5%(P<0.05)。两组患者治疗后不同时间点CMT均有差异(P<0.05)。

结论：康柏西普联合多波长多点扫描激光PRP治疗早期PDR可减少激光术中玻璃体积血的发生率，减轻黄斑水肿，改善患者视力，其作用优于单纯PRP。

METHODS: Retrospective case control study. A total of 102 eyes of 80 cases with proliferative diabetic retinopathy without proliferative fiber membrane from retinal or vitreous hemorrhage were recorded. The eyes were divided into two groups according to the therapeutic methods: group A included 60 eyes of 48 cases received only PRP; group B included 42 eyes of 32 cases received intravitreal injection of 0.5mg conbercept before PRP. All patients were given PRP with multiple wavelength and multispot pattern scan laser(NIDEK MC-500VIXI)and completed in twice with the interval time 3-7d. The patients were received supplementary laser therapy after 3mo according to fundus fluorescein angiography(FFA)results. The therapeutic effect and related complications were observed in two groups, the best corrected visual acuity(BCVA)of 3mo after PRP was recorded and the changes of central macular thickness(CMT)were compared. All patients were followed up for at least 3mo.

RESULTS: Incidence rate of vitreous hemorrhage and macular edema happened or became worse in group A was obviously higher than group B, the difference was statistically significant(P<0.05). The effective rate was 73.33% in group A and 90.48% in group B at 3mo after PRP and the difference was statistically significant(P<0.05). The CMT values at different time points after treatment in the two group showed a significant difference(P<0.05).

CONCLUSION: Intravitreal injection of conbercept combined with PRP with multiple wavelength and multispot pattern scan laser as a treatment for early proliferative diabetic retinopathy can reduce vitreous hemorrhage in the process of PRP and macular edema, and is more effective with better visual acuity recovery compared with only PRP.