目的：探究玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿(DDME)的眼表改变。

方法：选取2019-01/06于我院眼科被诊断为DDME的患者20例，均为右眼发病，将右眼纳入试验组，左眼(未发生糖尿病性黄斑水肿)纳入对照组，试验组均行3次玻璃体腔注射康柏西普，对照组不采取任何治疗操作。观察治疗前和3次治疗后第1d矫正视力、眼压、浅表点状上皮糜烂情况、泪河高度、眼表症状及体征(OSDI)评分、泪液分泌试验(SⅠt)及角膜荧光素染色(CSF)评分。

结果：治疗前，两组眼压、泪河高度、OSDI评分、SⅠt、CSF评分均无差异(P>0.05)，且两组均未出现浅表点状上皮糜烂情况，但对照组矫正视力显著优于试验组(0.50±0.20 vs 1.65±0.35，P<0.05)。治疗后，试验组矫正视力、泪河高度、SⅠt明显低于对照组，OSDI和CSF评分明显高于对照组(均P<0.05)，眼压升高幅度较对照组更大，但两组无差异(P>0.05)，而试验组19眼出现了浅表点状上皮糜烂情况。与治疗前比较，试验组治疗后矫正视力明显改善，泪河高度和SⅠt明显降低，OSDI和CSF评分明显升高(均P<0.05)，但眼压无明显变化(P>0.05)； 对照组各观察指标均无明显变化(P>0.05)。

结论：玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿会损伤眼表。

METHODS: Twenty patients(20 eyes, right eyes)diagnosed as DDME and requiring vitreous injection of conbercept in the Department of Ophthalmology, the First Affiliated Hospital of Nanchang University from January 2019 to June 2019, were selected as experiment group. Experiment goup was treated with three vitreous injections of Conbercept. The left eyes of the patients without macular edema were treated as control group without any treatment. Before operation and on the first day after operation, we used corrected visual acuity, superficial punctate epithelial erosion(SPEE), lacrimal river height, intraocular pressure, symptom and sign scores, Schirmer I test(S I t)and corneal fluorescein staining(CSF)to estimate eyes.

RESULTS: Before treatment, there was no difference in intraocular pressure, the height of lacrimal river, OSDI score, S I t, CSF score between the two groups(P>0.05), and there was no superficial punctate epithelial erosion in both groups, but the corrected visual acuity of the control group was significantly better than that of the experimental group(0.50±0.20 vs 1.65±0.35, P<0.05). After treatment, the corrected visual acuity, lacrimal river height and S I t in the experimental group were significantly lower than those in the control group, OSDI and CSF scores were significantly higher than those in the control group(all P<0.05), and the intraocular pressure increased more significantly than that in the control group, but there was no difference between the two groups(P>0.05). Compared with before treatment, the corrected visual acuity of the experimental group was significantly improved, the lacrimal river height and S I t were significantly decreased, OSDI and CSF scores were significantly increased(P<0.05), but the intraocular pressure had no significant change(P>0.05); the observation indexes of the control group had no significant changes(P>0.05).

CONCLUSION: Intravitreal injection of conbercept in the treatment of diffuse diabetic macular edema can damage the ocular surface.