目的：评估玻璃体腔内抗VEGF治疗糖尿病黄斑水肿(DME)24mo后的现实生活剖析和视觉效果。

方法：本研究包括了2012-06/2016-12接受玻璃体腔内注射的视网膜内和/或视网膜下液体和基线中心黄斑厚度(CMT)超过300μm的DME患者。在基线处3，6，12，18和24mo评估视力(VA)和CMT的变化，以及患者就诊和玻璃体腔内注射总数。

结果：研究包含40例患者(54眼)。基线处3mo LogMAR视力从0.67±0.47提高到0.59±0.43并在12mo内保持3.5±2.19次注射。12mo和24mo时平均就诊次数分别为9±2.39和15.48±4.84。基线处平均CMT为450±153μm，12mo和24mo时分别降至385±141μm和305±111μm(P<0.001)。

结论：PRN方法在治疗DME中可以保持视力稳定并改善黄斑水肿，但在主动疗法中，较低的就诊负担可能会获得类似的或更好的治疗效果。

METHODS: Treatment naive central-involved DME patients with intraretinal and/or subretinal fluid and baseline central macular thickness(CMT)over 300 μm in spectral domain optic coherence tomography scans who received intravitreal injections between June 2012 and December 2016 were included in the study. The changes in visual acuity(VA)and CMT, and total number of patient visits and intravitreal injections were assessed in the baseline of 3, 6, 12, 18 and 24mo.

RESULTS: Totally 54 eyes of 40 patients were included. VA at baseline improved from 0.67±0.47 LogMAR to 0.59±0.43 LogMAR at 3mo and maintained with 3.5±2.19 injections throughout 12mo. The average number of visits was 9±2.39 and 15.48±4.84 at 12mo and 24mo, respectively. The mean CMT at baseline was 450±153μm and decreased to 385±141μm and 305±111μm at 12 and 24mo, respectively(P<0.001).

CONCLUSION: Pro re nata(PRN)approach in DME treatment may keep the VA stable and reduce macular edema, but probably similar or better treatment effectivity could be obtained with a lower visit burden in proactive regimens.