目的：观察玻璃体腔注射雷珠单抗联合视网膜激光光凝治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的临床疗效。

方法：收集我院2013-08/2016-03收治的经散瞳眼底检查、眼底荧光血管造影(FFA)及光学相干断层扫描(OCT)检查确诊的BRVO继发黄斑水肿患者，随机分为2组，最终回访3mo时共47例47眼。观察组采用玻璃体注射雷珠单抗2wk后联合静脉回流区视网膜激光光凝治疗25例25眼，对照组采用单纯玻璃体注射雷珠单抗治疗22例22眼。比较两组患者治疗后1mo的最佳矫正视力(BCVA)、眼压(IOP)、黄斑中心视网膜厚度(CMT)以及并发症情况。

结果：两组治疗后1mo BCVA、CMT与治疗前比较，差异均有统计学意义(P<0.01)，而IOP与治疗前比较无统计学意义(P>0.05)； 治疗后1mo两组间BCVA、IOP比较差异均无统计学意义(P>0.05)，而组间CMT比较差异有统计学意义(P<0.01)。

结论：玻璃体注射雷珠单抗联合阻塞静脉回流区视网膜光凝治疗BRVO的临床疗效明显优于单纯玻璃体注射雷珠单抗治疗，且激光治疗过程中不刺激黄斑，安全性较高。

METHODS: A total of 47 cases(47 eyes)of patients diagnosed of macular edema secondary to BRVO by fundus examination, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were included who were admitted to our hospital from August 2013 to March 2016. All patients were divided into two groups randomly, 47 of them finished the follow up. observation group composed of 25 patients(25 eyes)who underwent ranibizumab injection and after 2wk they received retinal laser photocoagulation for blocking venous reflux area, and control group consisting of 22 cases(22 eyes)were given intravitreal injection of ranibizumab alone. The best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular retinal thickness(CMT)and the incidence of complications of patients from two groups were compared at the first month after the treatment.

RESULTS: Observation group and control group's BCVA and CMT were significantly different at 1mo after treatment compared with before treatment(P<0.01), but IOP were not different(P>0.05). The BCVA at 1mo after treatment were not different between the two groups(P>0.05), the CMT were significantly different(P<0.01).

CONCLUSION: The clinical effect of ranibizumab injection combined with laser photocoagulation for blocking venous reflux area has advantages when compared with ranibizumab injection alone in the treatment of branch retinal vein occlusion, and laser photocoagulation does not stimulate macula with higher security.