目的：使用频域OCT(spectral domain-optical coherence tomography，SD-OCT)评估玻璃体腔注射雷珠单抗治疗因糖尿病和视网膜静脉阻塞继发的黄斑水肿后视网膜厚度和脉络膜厚度的改变，并探究其变化的相关因素。

方法：选取2016-03/2017-07在我院眼科因糖尿病或视网膜静脉阻塞继发黄斑水肿收治入院接受玻璃体腔雷珠单抗注射术的患者36例36眼。使用SD-OCT测量术前和术后1、3、6mo的中心凹下脉络膜厚度与黄斑部视网膜厚度，分别评估玻璃体腔注射雷珠单抗治疗不同疾病引起黄斑水肿后的视网膜厚度和脉络膜厚度改变。同时探讨治疗后黄斑部视网膜厚度改变以及脉络膜厚度改变的相关因素。

结果：本研究纳入36例36眼接受玻璃体腔注射雷珠单抗治疗黄斑水肿患者。雷珠单抗治疗不同原因引起的黄斑水肿后，黄斑部视网膜厚度与中心凹下脉络膜厚度均较术前减小，不同随访时间的改变量有差异(F_CRT=40.876，P_CRT<0.001； F_SFCT=46.319，P_SFCT<0.001)。在糖尿病继发的黄斑水肿组，中心凹下脉络膜厚度改变量与术前中心凹下脉络膜厚度相关，黄斑部视网膜厚度改变量与术前黄斑视网膜厚度、空腹血糖水平相关。在视网膜静脉阻塞组，中心凹下脉络膜厚度改变量与术前中心凹下脉络膜厚度相关，黄斑部视网膜厚度改变量与术前黄斑部视网膜厚度、发病时间以及阻塞部位相关。

结论：玻璃体腔注射雷珠单抗治疗不同原因继发的黄斑水肿后，SD-OCT可测量到术后黄斑部视网膜厚度明显减小，中心凹下脉络膜厚度明显减小。脉络膜厚度的改变量与术前脉络膜厚度相关。糖尿病继发的黄斑水肿治疗后，黄斑部视网膜厚度的改变量与术前黄斑视网膜厚度及空腹血糖水平相关； 视网膜静脉阻塞继发的黄斑水肿治疗后，黄斑视网膜厚度改变量与术前黄斑部视网膜厚度、发病时间以及阻塞部位相关。

METHODS: Patients were recruited from March 2016 to July 2017 diagnosed with diabetic macular edema or retinal vein occlusion-macular edema. Subfoveal choroidal thickness(SFCT)and central retinal thickness(CRT)of all eyes were measured by SD-OCT preoperatively and at 1, 3, 6mo after operation. The change of retinal thickness and choroidal thickness after intravitreal ranibizumab injection for macular edema caused by different diseases were evaluated. Moreover, the potential determinants were studied about the change of retinal thickness and choroidal thickness.

RESULTS: Thirty-six eyes of 36 patents with macular edema were treated with intravitreal ranibizumab injection. After the intravitreal ranibizumab injection, the CRT and SFCT decreased, when compared with the CRT and SFCT preoperative. There was a significant difference in the change of CRT and SFCT in different time points of following-up(F_CRT=40.876, P_CRT<0.001; F_SFCT=46.319, P_SFCT<0.001). In diabetic macular edema group, the change of SFCT was associated with the preoperative SFCT, and the change of CRT was correlated with preoperative CRT and the fast blood glucose level. In retinal vein occlusion-macular edema group, the change of SFCT was associated with the preoperative SFCT, the change of CRT was associated with preoperative CRT, the obstructive positions and the onset time of disease.

CONCLUSION: Reduction of choroidal thickness and retinal thickness in macular edema caused by different diseases can be detected with SD-OCT after intravitreal injections of ranibizumab. The reduction of choroidal thickness was correlated with the preoperative choroidal thickness. In diabetic macular edema eyes, the reduction of retinal thickness was correlated with preoperative CRT and the fast blood glucose level. Whereas, in retinal vein occlusion-macular edema eyes, the reduction of retinal thickness was correlated with the preoperative CRT, the obstructive positions and the onset time.