目的：评价玻璃体腔注射雷珠单抗(IVR)联合亚阈值微脉冲(STMP)黄激光治疗糖尿病性黄斑水肿(DME)的疗效。

方法：回顾性研究。选择2022-03/2023-03本院收治的DME患者98例98眼，根据治疗方式不同分为：对照组49例49眼采用STMP黄激光治疗，研究组49例49眼采用IVR联合STMP黄激光治疗。比较两组患者治疗前后最佳矫正视力(BCVA)、视网膜新生血管(RNV)渗漏面积、黄斑中心凹旁厚度(PMT)、黄斑中心厚度(FMT)、中心视网膜厚度(CRT)、中心凹无血管区面积(FAZ)、采用中文版低视力者生活质量量表(CLVQOL)评估生活质量、并发症发生情况，并检测两组患者治疗前后血清一氧化氮合酶(NOS)、血管内皮生长因子(VEGF)水平。

结果：治疗3 mo后，两组患者BCVA均优于治疗前，RNV渗漏面积、PMT、FMT、CRT、FAZ、血清VEGF水平均小于治疗前，两组患者血清NOS水平、CLVQOL各维度评分均高于治疗前(均P<0.05)，且以上各指标研究组均优于对照组(均P<0.05)。所有患者均未发生眼部及全身并发症。

结论：IVR联合STMP黄激光治疗DME，可提高患者视力，减小RNV渗漏面积、PMT、FMT、CRT、FAZ，调节血清NOS、VEGF水平，改善患者生活质量，且安全性好。

METHODS: Retrospective study. A total of 98 DME patients(98 eyes)admitted to our hospital from March 2022 to March 2023 were enrolled and divided into two groups based on treatment methods: the control group(49 eyes)received STMP yellow laser therapy alone, while the study group(49 eyes)underwent combined IVR and STMP yellow laser therapy. Comparisons were made between the two groups regarding best corrected visual acuity(BCVA), retinal neovascularization(RNV)leakage area, parafoveal macular thickness(PMT), foveal macular thickness(FMT), central retinal thickness(CRT), and foveal avascular zone(FAZ)area, quality of life was assessed using the Chinese-version low vision quality of life questionnaire(CLVQOL), and complication rates were recorded. Additionally, serum levels of nitric oxide synthase(NOS)and vascular endothelial growth factor(VEGF)were measured before and after treatment in both groups.

RESULTS: At 3 mo after treatment, both groups showed improved BCVA compared to baseline, with reduced RNV leakage area, PMT, FMT, CRT, FAZ, and serum levels of VEGF, while serum NOS levels and all CLVQOL domain scores were higher than pre-treatment(all P<0.05). Furthermore, the study group demonstrated superior outcomes in all these parameters compared to the control group(all P<0.05), and no ocular or systemic complications occurred in any patient.

CONCLUSION: IVR combined with STMP yellow laser for DME improves visual acuity, reduces RNV leakage area, PMT, FMT, CRT, and FAZ, modulates serum NOS and VEGF levels, enhances quality of life, and demonstrates good safety.