方法：将2016-01/2020-01在本院诊治的BRVO继发ME患者147例147眼随机分为观察组(73眼)和对照组(74眼)，观察组接受玻璃体腔注射TA联合黄斑区格栅样光凝治疗，对照组接受玻璃体腔注射康柏西普联合黄斑区格栅样光凝治疗。随访6mo，比较两组的疗效及安全性指标。

结果：治疗后两组最佳矫正视力(BCVA，LogMAR)均较治疗前改善； 治疗后1mo时观察组BCVA优于对照组(0.22±0.15 vs 0.27±0.13，P<0.05)； 治疗后6mo时观察组中年龄<50岁患者BCVA显著优于对照组中年龄<50岁患者(0.09±0.04 vs 0.14±0.06，P<0.05)，两组中浆液性视网膜脱离(SRD)型患者BCVA均显著优于囊样水肿(CME)型与混合型患者，CME型患者BCVA均显著优于混合型患者(P<0.05)，但两组之间各ME分型亚组患者BCVA均无差异(P>0.05)。治疗后两组黄斑中心凹视网膜厚度(CMT)均较治疗前明显下降； 治疗后3mo时观察组CMT高于对照组(309.76±84.24μm vs 258.75±88.76μm，P<0.01)。治疗后1wk，1、3、6mo时观察组眼压均高于对照组(P<0.01)。治疗后6mo时，两组浅层毛细血管(SCP)血流密度较治疗前明显上升(P<0.05)，深层毛细血管(DCP)血流密度、中心凹无血管区(FAZ)面积则未见明显改变(P>0.05)。观察组眼压升高发生率高于对照组(28.8% vs 14.9%)，玻璃体腔注射次数低于对照组(1.21±0.74次vs 3.62±2.08次)。

结论：TA联合黄斑区格栅样光凝治疗BRVO继发ME可短期内将视力维持在一定水平，在视力、CMT上的获益与康柏西普联合黄斑区格栅样光凝治疗相当，但存在眼压升高现象，需加强眼压监测。

METHODS: A total of 147 patients(147 eyes)with ME secondary to BRVO treated in the hospital were enrolled between January 2016 and January 2020. They were randomly divided into observation group(73 eyes)and control group(74 eyes). The observation group was given intravitreal injection of TA and macular grid photocoagulation, while control group was given intravitreal injection of conbercept and macular grid photocoagulation. All were followed up for 6mo. Efficacy and safety indexes between the two groups were compared.

RESULTS:After treatment, best corrected visual acuity(BCVA, LogMAR)in both groups was improved. At 1mo after treatment, BCVA in observation group was better than that in control group(0.22±0.15 vs 0.27±0.13, P<0.05). At 6mo after treatment, BCVA of patients under 50 years in observation group was significantly better than that of patients under 50 years in control group(0.09±0.04 vs 0.14±0.06, P<0.05).BCVA was the best in patients with type serous retinal detachment(SRD), followed by type ME and mixed type(P<0.05). However, there was no significant difference in BCVA between any two groups in ME classifications(P>0.05). After treatment, central macular thickness(CMT)in both groups was significantly decreased. At 3mo after treatment, CMT in observation group was higher than that in control group(309.76±84.24μm vs 258.75±88.76μm, P<0.01). At 1wk, 1, 3 and 6mo after treatment, intraocular pressure in observation group was higher than that in control group(P<0.01). At 6mo after treatment, blood flow density of superficial capillary plexus(SCP)in both groups was significantly higher than that before treatment(P<0.05), but there was no significant change in blood flow density of deep capillary plexus(DCP)or the area of foveal avascular zone(FAZ)(P>0.05). The incidence of increased intraocular pressure was higher in observation group than control group(28.8% vs 14.9%), and times of intravitreal injection were fewer than those in control group(1.21±0.74 times vs 3.62±2.08 times).

CONCLUSION: TA combined with macular grid photocoagulation in the treatment of ME secondary to BRVO can maintain visual acuity at a certain level in the short term. The curative effect is comparable to that of conbercept combined with macular grid photocoagulation in terms of improving visual acuity and CMT. However, there is increased intraocular pressure, and the intraocular pressure monitoring needs to be strengthened.