目的：探讨渗出型老年性黄斑变性(AMD)伴浆液性视网膜色素上皮脱离(serous retinal pigment epithelial detachment，SPED)患者应用雷珠单抗的治疗效果。

方法：选取2015-02/2016-02在我院治疗的渗出型AMD伴SPED患者60例60眼，给予玻璃体腔注射雷珠单抗(intravitreal injection of ranibizumab，IVR)治疗，检查患者治疗前后最佳视力矫正(bestcorrected visual acuity，BCVA)、PED高度和容积、黄斑中心凹视网膜厚度(central fovea thickness，CFT)以及房水中血管内皮生长因子(vascular endothelial growth factor，VEGF)。

结果：患者治疗后1、3、6mo BCVA分别为0.6±0.1、0.4±0.1和0.3±0.1，均明显较治疗前改善，差异均有统计学意义(P<0.05)； 患者治疗后1、3、6mo PED高度和容积均较治疗前降低，差异均有统计学意义(P<0.05)，其中治疗后6mo 患者PED高度和容积分别为240.02±35.10μm和0.310±0.120mm³； 患者治疗后6mo CFT为290.02±33.10μm，明显低于治疗前及治疗后1mo，差异均有统计学意义(P<0.05)； 患者治疗后1、3、6mo房水VEGF均较治疗前降低，差异均有统计学意义(P<0.05)，其中治疗后6mo患者房水VEGF为149.11±28.89pg/mL； 治疗期间未发现有眼内炎、葡萄膜炎等不良反应发生。

结论：IVR治疗渗出型AMD伴SPED有较好的效果，能有效提高患者视力，降低PED高度和容积以及房水VEGF浓度，且安全可靠。

METHODS: We Selected 60 elderly patients(60 eyes)with AMD and SPED in our hospital from February 2015 to February 2016, treated by intravitreal injection of ranibizumab. The best corrected visual acuity(BCVA), PED height and volume, central fovea thickness(CFT)and aqueous humor vascular endothelial growth factor(VEGF)were measured before and after treatment.

RESULTS: The BCVA of patients with after treatment for 1, 3 and 6mo were 0.6±0.1, 0.4±0.1 and 0.3 ±0.1, and were significantly higher than those before treatment(P<0.05). At 1, 3 and 6mo after treatment PED height and volume were significantly lower than before treatment(P<0.05), of which 6mo after the treatment PED height and volume were 240.02±35.10μm and 0.310±0.120mm³. At 6mo after treatment CFT was 290.02±33.10μm, significantly lower than before and 1mo after treatment(P<0.05). At 1, 3 and 6mo after treatment VEGF were lower than those before treatment(P<0.05), in which 6mo after the treatment aqueous humor VEGF was 149.11±28.89pg/mL. No endophthalmitis, uveitis and so on adverse reactions were observed during treatment.

CONCLUSION: IVR has a good effect in the treatment of exudative AMD in elderly patients with serous PED, which can effectively improve the visual acuity of patients, reduce the height and volume of PED and the concentration of VEGF in aqueous humor, and it is safe and reliable.