目的：观察玻璃体腔注射康柏西普治疗视网膜分支静脉阻塞(BRVO)继发不同类型黄斑水肿(ME)的疗效。

方法：选取BRVO继发ME的患者70例70眼。基于OCT形态学表现分为3组：囊样型水肿(CME，24眼)、弥漫型水肿(DRT，22眼)、伴有神经上皮层脱离型水肿(SRD，24眼)。所有患者行玻璃体腔注射0.5mg(0.05mL)康柏西普治疗，治疗后1、6mo，比较三组BCVA(LogMAR)、黄斑区中央视网膜厚度(CMT)、黄斑中心无血管区面积(FAZ)、视网膜浅层毛细血管区血流密度(SCP)和深层毛细血管区血流密度(DCP)、注射次数的差异。

结果：随访6mo，CME组、DRT组、SRD组患眼BCVA值(0.24±0.13、0.11±0.07、0.33±0.13)、CMT(268.75±19.01、245.64±23.20、277.00±21.21μm)均呈明显下降趋势，FAZ(0.37±0.09、0.30±0.08、0.36±0.03mm²)呈明显变小趋势，SCP(46.18%±3.21%、47.49%±3.48%、42.76%±3.66%)、DCP(43.50%±4.34%、47.69%±2.76%、43.88%±3.54%)呈明显增加趋势(均P<0.01)。治疗6mo时，DRT组在提高BCVA、降低CMT，减小FAZ面积，增加SCP及DCP密度等方面均优于CME组和SRD组。随访6mo DRT组的注射次数(2.55±0.69次)最少(F=5.584，P<0.05)。

结论：玻璃体腔注射康柏西普均可显著改善BRVO继发不同类型ME患眼的视力，降低CMT，减小FAZ面积，增加SCP及DCP密度，其中DRT疗效最佳，注射次数最少。

METHODS: A total of 70 patients(70 eyes)with ME secondary to BRVO were classified as cystoid macular edema(CME group, 24 eyes), diffuse retinal thickening(DRT group, 22 eyes)and serous retinal detachment(SRD group, 24 eyes)according to features under OCT examination. After an initial intravitreal injection of 0.5mg(0.05mL)conbercept(IVIC). The changes of best corrected visual acuity(BCVA), central macular thickness(CMT), foveal avascular zone(FAZ), vascular density of superficial capillary plexus(SCP), vascular density of deep retinal capillary plexus(DCP)and the injection times were compared among three groups after 1, 6mo treatment.

RESULTS: After 6mo follow up, the BCVA(0.24±0.13、0.11±0.07、0.33±0.13)and the CMT(268.75±19.01、245.64±23.20、277.00±21.21μm)of the three groups showed a significant downward trend; The FAZ(0.37±0.09、0.30±0.08、0.36±0.03mm²)of the three groups showed a significant decreased trend; The SCP(46.18%±3.21%、47.49%±3.48%、42.76%±3.66%)and the DCP(43.50%±4.34%、47.69%±2.76%、43.88%±3.54%)of the three groups showed a significant increased trend(P<0.01). After 6mo treatment, DRT group was better than CME group and SRD group in improving BCVA, reducing CMT and FAZ area, increasing the density of SCP and DCP. The DRT group had the least injection numbers(2.55±0.69)(F=5.584, P<0.05).

CONCLUSION: The intravitreal injection of conbercept significantly improved the BCVA, reduced the CMT and the FAZ, increased the vascular density of SCP and DCP of different patterns of ME. Best outcomes were achieved in DRT group.