目的：评估地塞米松玻璃体内植入剂(DEX-I)治疗视网膜静脉阻塞(RVO)继发不同类型黄斑水肿的疗效。

方法：回顾性研究。收集2019-07/2020-06在大连市第三人民医院诊断为RVO-ME并接受DEX-I(0.7mg)为初始治疗的患者46例46眼，根据光学相干断层扫描成像(OCT)形态特征分为弥漫性视网膜增厚型(DRT型，13例13眼)、黄斑囊样水肿型(CME型，22例22眼)、浆液性视网膜脱离型(SRD型，11例11眼)。分别于治疗前、治疗后1、2、3mo观察并比较3种黄斑水肿分型患者最佳矫正视力(BCVA)和中心凹视网膜厚度(CRT)情况。

结果：与治疗前比较，DRT型、CME型、SRD型患者BCVA治疗后1、2、3mo均显著改善，CRT均显著降低(均P<0.017)。治疗后3mo，DRT型和SRD型患者BCVA(0.21±0.12、0.22±0.10LogMAR)均显著优于CME型(0.45±0.14LogMAR，均P<0.017)，CRT(254.08±49.07、248.92±44.19μm)均显著低于CME型(314.70±92.66μm，均P<0.017)。

结论：DEX-I治疗RVO继发各种OCT类型黄斑水肿均有效，CME型治疗反应相较DRT型和SRD型差。

METHODS:A retrospective observational case study was conducted. A total of 46 patients(46 eyes)who were diagnosed with RVO-macular edema(ME)and received DEX-I of 0.7 mg as the initial treatment in Dalian No.3 People's Hospital from July 2019 to June 2020 were collected. According to the morphological characteristics of optical coherence tomography(OCT), they were divided into diffuse retinal thickening type(DRT type, 13 patients, 13 eyes), cystoid macular edema type(CME type, 22 patients, 22 eyes )and serous retinal detachment type(SRD type, 11 patients, 11 eyes ). The best corrected visual acuity(BCVA)and central retinal thickness(CRT)of patients with three types of macular edema were observed and compared before treatment and 1, 2 and 3mo after treatment.

RESULTS:Compared with before treatment, BCVA of patients with DRT, CME and SRD were significantly improved at 1, 2 and 3mo after treatment, and CRT was significantly decreased(all P<0.017). At 3mo after treatment, BCVA(0.21±0.12, 0.22±0.10LogMAR)of DRT and SRD patients was significantly better than that of CME(0.45±0.14LogMAR, both P<0.017), and CRT(254.08±49.07, 248.92±44.19μm)was significantly lower than that of CME(314.70±92.66 μm, both P<0.017).

CONCLUSIONS: DEX-I is effective in the treatment of various OCT types of macular edema secondary to RVO, and the treatment response of CME type is worse than that of DRT and SRD types.