目的：使用光学相干断层扫描(OCT)研究累及中心凹的糖尿病性黄斑水肿(DME)患者玻璃体腔内注射雷珠单抗或阿柏西普后中心凹下脉络膜厚度的变化。

方法：纳入本院确诊累及中心凹的DME患者17例，其中玻璃体腔内注射雷珠单抗0.5mg/0.05mL患者9例，玻璃体腔内注射阿柏西普2mg/0.05mL患者8例，所有患者均接受每月1次，共3次治疗。使用增强深度成像-光学相干层析成像(EDI-OCT)观察两组患者治疗前和治疗后1mo中心凹下脉络膜厚度、视力和视网膜中央厚度的变化情况。

结果：两组患者通过3次玻璃体腔注射抗VEGF后，中心凹下脉络膜厚度和视网膜中央厚度明显较治疗前变薄，视力较治疗前明显改善(均P<0.05)，而两组间中心凹下脉络膜厚度、视网膜中央厚度和视力比较均无差异(均P>0.05)。治疗前中心凹下脉络膜厚度与视力改善之间无明显相关性(r_s=-0.269，P=0.296)。治疗后脉络膜厚度变化与视力改善、视网膜中央厚度变化以及患者年龄之间均无明显相关性(均P>0.05)。

结论：玻璃体腔内注射雷珠单抗和阿柏西普均可以使累及中心凹的DME患者中央凹下脉络膜和视网膜中央厚度变薄并显著改善视力。

AIM: To investigate for any detectable change in sub-foveal choroidal thickness following intravitreal injections of Ranibizumab or Aflibercept in patients with central involving diabetic macula edema(DME), evidenced by optical coherence tomography(OCT).

METHODS: Totally 17 patients with central involving DME who required and agreed to intravitreal anti-VEGF injection were invited to be the subject of this study. These injection-naive subjects were undergone three loading doses of monthly intravitreal anti-VEGF(Ranibizumab 0.5 mg/0.05 mL for 9 patients or Aflibercept 2 mg/0.05 mL for 8 patients)injection, and a clinic review appointment 1mo after the third injection. The changes of foveal choroidal thickness, visual acuity and central retinal thickness at 1mo were observed before and after treatment in 2 groups by enhanced depth image-optical coherence tomography(EDI-OCT).

RESULTS: We recorded a significant sub-foveal choroidal thinning and vision improvement after three loading doses of anti-VEGF(all P<0.05). The thinning effect between Ranibizumab and Aflibercept group was insignificant(all P>0.05). There was no significant correlation between pre-treatment sub-foveal choroidal thickness and vision improvement(r_s=-0.269, P=0.296). There was also no significant correlation between choroidal thickness changes with vision improvement, central retinal thickness change and age of subjects(all P >0.05).

CONCLUSION: Intravitreal Ranibizumab and Aflibercept injections both leads to significant sub-foveal choroidal thinning in DME subjects. It was accompanied with significant vision improvement with no evidence of immediate detrimental effect of choroidal thinning. Future research with a longer study duration would help in establishing the duration and long term effect of choroidal thinning.