目的：研究玻璃体腔注射雷珠单抗治疗视网膜静脉阻塞(RVO)继发黄斑水肿的疗效及其影响因素。

方法：回顾性病例研究。收集2020-04/2021-02于我院治疗的RVO继发黄斑水肿患者61例61眼，其中BRVO患者30例30眼，CRVO患者31例31眼。所有患者均完成了3次雷珠单抗(0.5mg)玻璃体腔注药治疗，部分患眼进行了视网膜激光治疗。治疗(首次玻璃体腔注药)后随访3mo，观察治疗后视力、眼压及黄斑中心凹厚度(CRT)情况，并记录眼部及全身并发症发生情况。

结果：纳入患者治疗后视力均较治疗前显著改善，CRT均较治疗前显著降低(P<0.01)，且BRVO和CRVO患者中治疗前视力≤1(LogMAR)的患者3次玻璃体腔注药后视力均优于治疗前视力>1的患者(P<0.01)，但CRT无差异(均P>0.05)。BRVO和CRVO患者中分别有12、8眼在3次玻璃体腔注药期间进行了病变区激光治疗，BRVO和CRVO患者中激光治疗和未激光治疗的患者3次玻璃体腔注药后视力和CRT均无差异(P>0.05)。随访期间未发现眼部及全身严重并发症的发生。

结论：雷珠单抗治疗RVO继发黄斑水肿具有良好的疗效和安全性，但基线视力可能对疗效具有一定影响。

METHODS:A retrospective case study. There were 61 patients(61 eyes)with macular edema secondary to RVO who treated in our hospital from April 2020 to February 2021, including 30 cases(30 eyes)of branch retinal vein occlusion(BRVO)patients and 31 cases(31 eyes)of central retinal vein occlusion(CRVO)patients. All patients received 3 times of intravitreal injections of ranibizumab(0.5mg), and some eyes underwent retinal laser therapy. The patients were followed up for 3mo after treatment(the first intravitreal injection)to observe the visual acuity, intraocular pressure, central retinal thickness(CRT)and record the occurrence of ocular and systemic complications.

RESULTS: The visual acuity of the included patients after treatment was significantly improved compared with that before treatment, and the CRT was significantly decreased compared with that before treatment(P<0.01), and after 3 times of intravitreal injections, the visual acuity of BRVO and CRVO patients with pre-treatment visual acuity≤1(LogMAR)was better than that of the patients with pre-treatment visual acuity>1(P<0.01), but there was no difference in CRT(all P >0.05). Among BRVO and CRVO patients, 12 and 8 eyes received retinal laser treatment during 3 times of intravitreal injections, respectively. The difference in visual acuity and CRT among the eyes treated with laser and those that were untreated was not significant(P>0.05). No ocular and systemic serious complications emerged during follow-up.

CONCLUSIONS: Ranibizumab has high efficacy and safety in the treatment of macular edema secondary to RVO, while visual acuity at baseline may help predict the prognosis.