方法：回顾性收集2019-06/2020-12就诊于郑州大学第一附属医院眼科的RVO-ME患者的临床资料，共计108例108眼，其中黄斑囊样水肿(CME)52例52眼、浆液性神经上皮脱离(SRD)38例38眼、弥漫性视网膜增厚(DRT)18例18眼。再将各类型ME患者根据治疗方式分为抗VEGF组与抗炎组，抗VEGF组注射雷珠单抗或阿柏西普，抗炎组注射地塞米松玻璃体内植入剂，收集各组患者术前及术后3mo最佳矫正视力(BCVA)、黄斑中央凹厚度(CMT)等观察指标并进行比较。

结果：各类型ME患者抗VEGF组与抗炎组术前基线资料均无差异(均P>0.05)。CME型患者抗VEGF组患者术后BCVA、CMT、CME囊腔直径总和与术前比较有差异(Z=-4.463、-4.541、-4.541，均P<0.001)，抗炎组患者术后BCVA、CMT、CME囊腔直径总和与术前比较有差异(Z=-3.743、-4.345、-4.372，均P<0.001)； 抗VEGF组患者与抗炎组患者术后CMT、CME囊腔直径总和比较无差异(Z=-1.017、-0.968，均P>0.05)，BCVA比较有差异(Z=-1.978，P<0.05)。SRD型患者抗VEGF组患者术后BCVA、CMT、SRD高度和术前比较有差异(Z=-4.111、-4.198、-4.198，均P<0.01)，抗炎组患者注射后BCVA、CMT、SRD高度较术前比较有差异(Z=-3.410、-3.408、-3.408，均P<0.05)； 两组患者术后BCVA和CMT比较无差异(Z=-0.857、-1.030，均P>0.05)，但抗炎组患者术后SRD高度明显低于抗VEGF组(Z=-2.117，P<0.05)。DRT型患者抗VEGF组患者术后BCVA和CMT较术前比较有差异(Z=-2.207、-2.521，均P<0.05)，抗炎组患者注射后BCVA和CMT较术前比较有差异(Z=-2.207、-2.803，均P<0.05)。两组患者术后BCVA和CMT比较无差异(Z=-0.359、-0.845，均P>0.05)。

结论：抗炎治疗及抗VEGF治疗对各种类型ME患者视力以及解剖学改善均有效果，且抗VEGF治疗对CME型患者BCVA提高优于抗炎治疗，对SRD型患者改善效果劣于抗炎治疗。

METHODS: The clinical data of RVO-ME patients who were treated in the Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University from 2019-06/2020-12 were retrospectively collected. A total of 108 cases(108 eyes)of RVO-ME patients were collected, including 52 cases(52 eyes)with cystoid macular edema(CME), 38 cases(38 eyes)with macular edema with serous retinal detachment(SRD), and 18 cases(18 eyes)with diffuse retinal thickening(DRT). Patients with various types of ME were further classified into anti-VEGF group and anti-inflammatory group. The observation metrics such as best corrected visual acuity(BCVA)and foveal thickness(CMT)before and 3mo after surgery were collected and compared in each group.

RESULTS: There was no difference in baseline data between the anti-VEGF group and the anti-inflammatory group in all types of ME patients(all P>0.05). Patients with CME in the anti-VEGF group in BCVA, CMT, and the sum of CME diameter after operation were different from that before operation(Z= -4.463, -4.541, -4.541, all P<0.001); the postoperative BCVA, CMT, and the sum of CME diameter in the anti-inflammatory group were significantly different from those before operation(Z= -3.743, -4.345, -4.372, all P<0.001); and there was no difference between the anti-VEGF group and the anti-inflammatory group in the postoperative CMT and the sum of CME diameter(Z= -1.017, -0.968, all P>0.05), but there was a difference in BCVA after operation in two groups(Z= -1.978, P<0.05). SRD patients in the anti-VEGF group had differences in postoperative BCVA, CMT, and SRD heights compared with preoperative ones(Z= -4.111, -4.198, -4.198, all P<0.01); the BCVA, CMT, and SRD height in the anti-inflammatory group after operation were different from those before operation(Z= -3.410, -3.408, -3.408, all P<0.05); and there was no difference in BCVA and CMT between the two groups after operation(Z= -0.857, -1.030, all P>0.05), but the postoperative SRD height in the anti-inflammatory group was significantly lower than that in the anti-VEGF group(Z= -2.117, P<0.05). DRT patients in the anti-VEGF group were significantly different in BCVA and CMT after operation compared with preoperative ones(Z= -2.207, -2.521, all P<0.05), and in the anti-inflammatory group after injection, BCVA and CMT were significantly different from preoperative ones(Z= -2.207, -2.521, all P<0.05). There were differences in BCVA and CMT after injection in the anti-inflammatory group compared with those before operation(Z= -2.207, -2.803, all P<0.05). There was no difference in postoperative BCVA and CMT between the two groups(Z= -0.359, -0.845, all P>0.05).

CONCLUSION: Anti-inflammatory and anti-VEGF treatments are effective for all kinds of ME in improving vision and reducing CMT. Anti-VEGF treatment is superior to anti-inflammatory treatment in improving BCVA of CME patients and is inferior to anti-inflammatory in decreasing SRD thickness of SRD patients.