【摘要】 目的 评估视网膜静脉阻塞继发黄斑水肿（RVO-ME）抗炎和抗血管内皮生长因子（VEGF）治疗后患者视功能和频域相干光层析成像术（SD-OCT）生物标志物的变化，为临床选择合适的治疗方案提供依据。方法 前瞻性病例研究。2019年6月至2021年11月在菏泽医学专科学校附属医院确诊的RVO-ME患者106例（106只眼），随机分为A、B两组，其中A组给予玻璃体腔内注射雷珠单抗治疗，B组给予玻璃体腔内注射地塞米松玻璃体腔内植入剂治疗。在基线和首次治疗后12个月记录最佳矫正视力（BCVA）、SD-OCT的生物标志物和不良反应，比较两组在治疗前后BCVA、 SD-OCT的变化和不良反应的发生率。结果 两组患者治疗后BCVA、SD-OCT生物标志物均显著改善（均P <0.01），在12个月时B组患者浆液性视网膜脱离（SRD）降度改善明显优于A组，治疗后B组患者视网膜内高反射灶（HRFs）数量明显少于A组。两组比较，外界膜（ELM）、椭圆体带（EZ）、视网膜内层结构紊乱（DRIL）的变化差异均无统计学意义（均P> 0.05）。两组治疗后球结膜下出血、晶状体混浊的发生率差异均无统计学意义，但B组24例患者出现眼压升高，明显高于A组。结论 抗炎和抗VEGF治疗对RVO-ME均有效，BCVA和SD-OCT生物标志物均有改善，在改善SRD方面，抗炎治疗优于抗VEGF治疗，在HRFs的数量上，抗炎和抗VEGF治疗之间没有差异。更多还原

【Abstract】 Objective To evaluate the changes in visual function and spectral domain optical coherence tomogra-phy(SD-OCT) biomarkers in patients with retinal vein obstruction secondary macular edema(RVO-ME) after antiinflammatory and anti-vascular endothelial growth factor(VEGF) treatment, and to provide evidence for clinical selection of appropriate treatment. Methods For prospective study, 106 patients(106 eyes) diagnosed with RVO-ME in the Affili-ated Hospital of Heze Medical College from June 2019 to November 2021 were randomly divided into two groups: A and B.Group A was given intravitreal injection of Ranibizumab, group B was given intravitreal injection of dexamethasone. Bio-markers of best corrected visual acuity(BCVA) and SD-OCT and adverse reactions were recorded at baseline and 12mo af-ter the first treatment, and changes in BCVA and SD-OCT and incidence of adverse reactions were compared between the two groups before and after treatment. Results BCVA and SD-OCT biomarkers were significantly improved in both groups after treatment(P < 0.01). Serous retinal detachment(SRD) degradation in group B was significantly better than that in group A at 12mo, and the number of hyperreflective retinal foci(HRFs) in group B was significantly less than that in group A after the treatment. Compared with the two groups, there was no statistical significance in the changes of external retinal membrane(ELM), ellipsoid zone(EZ) and thedisorganization of retinal innerlayers(DRIL)(P > 0.05). There was no significant difference in the incidence of subconjunctival hemorrhage and lens opacity between the two groups after treatment, but 10 patients in group B showed increased intraocular pressure(IOP), which was significantly higher than that in group A.Conclusions Both anti-inflammatory and anti-VEGF treatment were effective for RVO-ME, BCVA and SD-OCT biomarkers were improved, anti-inflammatory treatment was superior to anti-VEGF treatment in improving SRD, and there was no difference between anti-inflammatory and anti-VEGF treatment in the number of HRFs.更多还原