方法：回顾性分析复发性糖尿病黄斑水肿病例30例39眼，其中男18例23眼，女12例16眼，年龄54.20±11.50岁。对于确诊为复发性黄斑水肿患者行玻璃体腔内注射雷珠单抗0.05mL(0.5mg)，所有患者均行最佳矫正视力、眼压、裂隙灯显微镜检查、眼底前置镜、荧光素眼底血管造影、光学相干断层扫描(OCT)等检查。记录术前、术后最佳矫正视力、眼压、黄斑中心凹视网膜厚度(CRT)。以末次随访时检查结果作为疗效评价指标。

结果：随访6～12(平均8.69±2.26)mo，39眼注射次数为1～4(平均1.82±0.82)次。治疗前视力0.14±0.09，治疗后视力提高为0.33±0.21，差异具有统计学意义(t=8.11，P< 0.01)。OCT检查显示治疗后黄斑中心凹视网膜水肿明显减轻，治疗前CRT 495.74±147.84μm，治疗后CRT 219.33±62.17μm，差异具有统计学意义(t=10.68，P<0.01)。2眼术后黄斑中心凹视网膜厚度有下降，但是视力无提高。无术后视力下降病例。

结论：玻璃体腔内注射雷珠单抗治疗复发性糖尿病黄斑水肿是安全有效的。

METHODS: The study was a retrospective analysis of 30 cases of recurrent diabetic macular edema(39 eyes), including 18 males(23 eyes)and 12 females(16 eyes), aged 54.20±11.50 years. The patients, who were diagnosed to be with recurrent diabetic macular edema, were further treated with intravitreal injection of 0.05mL(0.5mg)ranibizumab. All the treated patients performed best corrected visual acuity, intraocular pressure, slit lamp microscope examination, fundus pre-set lens, fundus fluorescein angiography, and optical coherence tomography(OCT)examinations. The best corrected visual acuity, intraocular pressure and macular central retinal thickness(CRT)were recorded before and after the surgery. The results obtained from the last follow-up visit were used as the index for the evaluation of curative effects.

RESULTS: The follow-up periods ranged 6～12mo with the mean±standard deviation of 8.69±2.26mo. The injection numbers for each eye ranged 1～4 times with the mean±standard deviation of 1.82 ±0.82 times. The visual acuity before the treatment was 0.14±0.09, while significantly increased to 0.33±0.21 after the treatment(t=8.11, P<0.01). The macular OCT examination showed that macular edema was significantly alleviated after the treatment. The CRT was 495.74±147.84μm before the treatment, while significantly decreased to 219.33 ± 62.17μm after the treatment(t=10.68, P<0.01). Further specifically, CRT in 2 patients decreased without improvement of vision after the treatment, and no case of vision decrease after the treatment was observed.

CONCLUSION: Ranibizumab intravitreal injection is effective and safe in the treatment of recurrent diabetic macular edema.