目的：研究视网膜分支静脉阻塞继发黄斑水肿(BRVO-ME)抗血管内皮生长因子(VEGF)治疗后复发的相关危险因素。

方法：选取2021年2月至2022年6月在山东第二医科大学附属医院眼科就诊的BRVO-ME患者32例32眼，采取3+PRN的抗VEGF治疗方案，随访时间6 mo。连续3次抗VEGF治疗后，根据治疗后6 mo OCT的黄斑中心凹厚度(CMT)变化，分为无复发组和复发组，应用悬浮液相检测法检测房水中多种细胞因子含量，比较两组间一般资料、CMT及细胞因子含量的变化，分析其与BRVO-ME抗VEGF治疗后复发的相关性。

结果：无复发组19眼ME消退，复发组13眼ME复发或者未完全消退。与基线值相比，无复发组和复发组CMT在术后1 d，1、6 mo均有所改善(均P<0.05)。与无复发组相比，复发组在基线，术后1 d，6 mo的CMT值更大(均P<0.05)。复发组房水基线VEGF、单核细胞趋化蛋白-1(MCP-1)含量均显著高于无复发组(均P<0.05)。Spearman相关性分析显示，基线CMT与IL-1β、IL-5、IL-12、MCP-1及IP-10呈中度正相关(均P<0.05)。多因素逻辑回归分析显示，基线CMT、基线房水MCP-1含量均是ME复发的危险因素(OR>1，P<0.05)。

结论：基线CMT和房水MCP-1水平是BRVO-ME患者抗VEGF治疗后复发的危险因素，基线CMT较高和基线房水MCP-1表达水平高的患者抗VEGF治疗后更容易复发。

METHODS:A total of 32 patients(32 eyes)with BRVO-ME who were treated at the ophthalmology department of the Affiliated Hospital of Shandong Second Medical University from February 2021 to June 2022 were selected. They were treated with a 3+pro re nata (PRN)anti-VEGF regimen and followed up for 6 mo. Following 3 consecutive anti-VEGF injections, patients were categorized into a non-recurrence group and a recurrence group based on central macular thickness(CMT)measured by optical coherence tomography(OCT)at 6 mo post-treatment. Aqueous humor levels of various cytokines levels were quantified using suspension assay method. Demographic characteristics, CMT, and cytokine levels were compared between the two groups, and their correlations with the recurrence of BRVO-ME after anti-VEGF treatment were analyzed.

RESULTS:At 6 months post-treatment, ME resolved in 19 eyes(no recurrence group), while 13 eyes showed persistent or recurrent ME(recurrence group). Compared to baseline, the CMT significantly improved in both groups at 1 d, 1, and 6 mo post-treatment(all P<0.05). However, the recurrence group exhibited significantly higher baseline, 1 d and 6 mo post-treatment CMT values than the non-recurrence group(all P<0.05). The aqueous humor levels of VEGF and monocyte chemoattractant protein-1(MCP-1)at baseline were significantly higher in the recurrence group than the non-recurrence group(all P<0.05). Spearman correlation analysis revealed positive associations between baseline CMT and interlukin IL-1β, IL-5, IL-12, MCP-1 and IP-10 levels(all P<0.05). Multivariable Logistic regression analysis identified baseline CMT and MCP-1 levels as independent risk factors for BRVO-ME recurrence(OR>1, P<0.05).

CONCLUSION: Elevated baseline CMT and aqueous humor MCP-1 levels were identified as independent risk factors for BRVO-ME recurrence after anti-VEGF therapy. Patients exhibiting higher baseline CMT and MCP-1 levels demonstrated significantly increased susceptibility to recurrence.