目的： 评价双重激光(传统激光+微脉冲激光)联合单次玻璃体腔注射康柏西普对缺血型视网膜分支静脉阻塞继发黄斑水肿(IBRVO-ME)的临床效果。

方法： 采用前瞻性队列研究方法，将2017-11/2018-11符合纳入标准的IBRVO-ME患者共83例83眼随机分为双重激光+玻璃体腔单次注射康柏西普组(A组)42眼和传统激光+玻璃体腔单次注射康柏西普组(B组)41眼。观察两组患者基线值，治疗后1、3、6mo最佳矫正视力(BCVA)，黄斑中心凹厚度(CMT)等指标变化规律。

结果： 治疗后1mo与基线值比较：A组BCVA从0.88±0.11提升至0.43±0.19(P <0.01)，CMT从595.00±61.12μm下降至379.8±76.08μm(P<0.01)； B组BCVA从0.82±0.19提升至0.39±0.16(P<0.01)，CMT从601.70±81.37μm下降至381.50±70.92μm(P<0.01)； 两组间比较均无差异(P>0.05)。治疗后3mo与1mo比较：A组BCVA提升至0.13±0.07(P<0.01)，CMT下降至282.80±31.93μm(P<0.01)； B组BCVA保持在0.41±0.09(P=1.00)，CMT保持在395.80±34.53μm(P=0.99)； 两组间比较均有差异(P<0.01)。治疗后6mo与3mo比较：A组BCVA维持在0.28±0.12(P<0.01)，CMT维持在335.60±33.98μm(P =0.02)； B组BCVA反弹为0.77±0.15(P<0.01)，CMT反弹为579.60±19.61μm(P<0.01)，两组间比较有差异(P<0.01)。整个治疗过程无严重并发症发生。

结论： 双重激光(传统激光+微脉冲激光)联合玻璃体腔单次注射康柏西普对IBRVO-ME有较好的临床效果，并能维持在3mo以上。

METHODS: A prospective cohort study was conducted. 83 patients(83 eyes)participated in the study from November 2017 to November 2018. They were randomly divided into two groups. Group A(42 eyes)accepted the treatment of dual laser and single intravitreal injection with conbercept and group B(41 eyes)accepted only traditional laser treatment and single intravitreal injection with anti-VEGF, and the aim is to analysis the data including BCVA, CMT in follow-up visit after treatment 1, 3, 6mo.

RESULTS: After 1mo: in group A, BCVA improved from 0.88±0.11 to 0.43±0.19(P<0.01), CMT changed from 595.00±61.12 to 379.8±76.08μm(P<0.01). In group B, BCVA changed from 0.82±0.19 to 0.39±0.16(P<0.01)while CMT changed from 601.70±81.37 to 381.50±70.92 μm(P<0.01). There were no difference between two groups(P>0.05). After 3mo: in group A, BCVA raised to 0.13±0.07(P<0.01), CMT reduced to 282.80±31.93μm(P<0.01); in group B, BCVA hold on 0.41±0.09(P=1.00), CMT retained 395.80±34.53μm(P=0.99). The improvement of BCVA and CMT were better in group A(P<0.01). After 6mo: in group A, BCVA maintained 0.28±0.12(P<0.01), CMT keeped 335.60±33.98μm(P=0.02); in group B, BCVA rebounded to 0.77±0.15(P<0.01), CMT was 579.60±19.61μm(P<0.01). Both BCVA and CMT were better in group A than group B(P<0.01). No serious complications happened in all phases.

CONCLUSION: The treatment of dual laser and single intravitreal injection with conbercept for macular edema secondary to ischemic branch retinal vein occlusion can maintain good effect more than 3mo.