目的：探讨康柏西普联合曲安奈德球内注射治疗糖尿病性黄斑水肿的疗效。

方法：回顾性队列研究。合并黄斑水肿的糖尿病患者40例43眼，治疗前记录BCVA、IOP和OCT检查。根据治疗方式分为两组，A组患者给予玻璃体腔注射康柏西普联合曲安奈德治疗，B组给予玻璃体腔注射康柏西普治疗。分别于治疗后1d，1、4、8、12、24wk记录BCVA、IOP和CMT及并发症等情况。

结果：A组治疗后不同时间点的视力与治疗前(0.83±0.03)相比均有差异(P<0.05)，治疗8wk时达到最佳视力(0.23±0.04)； 治疗后CMT与治疗前(612.4±47.6μm)有差异(P<0.05)； 24wk内平均注射次数2.7次。B组治疗后不同时间点视力与治疗前(0.79±0.09)有差异(P<0.05)，治疗4wk时达到最佳视力(0.25±0.06)。治疗后CMT与治疗前(597.8±62.4μm)有差异(P<0.05)，24wk内平均注射次数3.6次。两组患者第一针与第二针治疗间隔时间有差异(P<0.05)。两组患者治疗前后眼压无差异(P>0.05)。

结论：康柏西普联合曲安奈德球内注射治疗糖尿病性黄斑水肿安全、有效、见效快，但疗效更持久，且可降低打针频率。

METHODS: This retrospective cohort study comprised of 43 eyes in 40 patients who suffered from DME. There were 2 groups, groups A and B, according to the different therapies. Group A(22 eyes of 21 patients)were treated with intravitreal injection of 0.5mg/0.05mL conbercept and 2mg triamcinolone acetonide(TA). Group B(21 eyes of 19 patients)were treated with intravitreal injection of 0.5mg/0.05mL conbercept. All the patients were followed up to 24wk. The best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)and complications were recorded and analyzed prior to operation and 1d, 1wk, 4wk, 8wk, 12wk and 24wk after operation.

RESULTS:Group A: the BCVA of 22 eyes of 21 patients treated with intravitreal injection of 0.5mg/0.05mL and 2 mg triamcinolone acetonide on 1d, 1wk, 4wk, 8wk, 12wk and 24wk were significantly different from that(LogMAR 0.83±0.03)prior to treatment(P<0.05), and the BCVA was achieved at 8wk(LogMAR 0.23±0.04). The CMT were significantly different from that(612.4±47.6μm)prior to treatment(P<0.05). The average number of injections was 2.7 injections within 24wk; Group B: the VA of 21 eyes in 21 patients treated with intravitreal injection of 0.5mg/0.05mL on 1d, 1wk, 4wk, 8wk, 12wk and 24wk were significantly different from that(LogMAR 0.79±0.09)prior to treatment(P<0.05), and the BCVA was achieved at 4wk(LogMAR 0.25±0.06). The CMT were significantly different from that(597.8±62.4μm)prior to treatment(P<0.05). The average number of injections was 3.6 injections within 24wk.There was statistically significant difference in the interval between the first and second injections of two groups(P<0.05). There were no significant difference in IOP.

CONCLUSION: In summary, combined intravitreal injection of conbercept and TA is a safe and effective treatment for DME. The effect is more durable and the injection frequency can be reduced. The combination of anti-VEGF and corticosteroids may be an effective treatment for DME.