目的：研究康柏西普对视网膜静脉阻塞性黄斑水肿(RVO-ME)患者不同光学相干断层扫描(OCT)生物标记物的影响，并分析其变化与视力预后的关系。方法：回顾性研究，收集2023年1月至2024年12月我院收治的RVO-ME患者57例57眼，其中视网膜中央静脉阻塞(CRVO)组25例25眼，视网膜分支静脉阻塞(BRVO)组32例32眼，所有患者均接受玻璃体腔注射康柏西普治疗(每月1次，共3次)。比较手术前后最佳矫正视力(BCVA)，不同OCT生物标记物的变化包括中央黄斑厚度(CMT)、视网膜内层结构紊乱(DRIL)的长度、高反射点(HRD)数量、视网膜内积液(IRF)、视网膜下积液(SRF)面积、椭圆体带(EZ)断裂的长度，并分析不同OCT生物标记物的变化与BCVA的关系。结果：与术前相比，术后3 mo BCVA(LogMAR)改善、CMT下降、DRIL长度缩短、HRD数量减少、IRF面积下降、SRF面积降低、EZ中断长度缩短(均P<0.05)。Spearman相关性分析表明：手术前后CMT、DRIL长度、HRD数量、IRF面积、SRF面积变化与BCVA变化均无相关性(P>0.05)，但EZ中断长度的变化与BCVA变化呈正相关(rs=0.34，P=0.011)，EZ断裂长度的变化与BCVA变化的拟合曲线R2=0.113，P=0.011。CRVO组和BRVO组患者手术前后BCVA、DRIL长度、HRD数量、IRF面积、SRF面积、EZ中断长度变化量比较均无差异(均P>0.05)，CMT变化量比较有差异(P=0.002)。结论：康柏西普可有效改善RVO-ME患者的多种OCT生物标记物，其中EZ中断修复是视力恢复的关键驱动因素，其稳定性可作为抗血管内皮生长因子治疗个体化决策的新指标。

AIM: To investigate the effects of Conbercept on various optical coherence tomography(OCT)biomarkers in patients with retinal vein occlusion-related macular edema(RVO-ME), and to analyze the correlation of these biomarker changes with visual prognosis.METHODS: Retrospective study. A total of 57 patients(57 eyes)with RVO-ME, including 25 patients(25 eyes)with central retinal vein occlusion(CRVO)and 32 patients(32 eyes)with branch retinal vein occlusion(BRVO), were enrolled in this study. All the patients received intravitreal injection of conbercept once a month, three times in total. The preoperative and postoperative best-corrected visual acuity(BCVA), and changes in OCT biomarkers, including central macular thickness(CMT), the length of disorganization of the retinal inner layers(DRIL), the number of hyperreflective dots(HRD), the area of intraretinal fluid(IRF), the area of subretinal fluid(SRF), and the length of ellipsoid zone(EZ)disruption were compared. Furthermore, the relationship of these changes with BCVA was analyzed.RESULTS:Compared with the baseline, at 3 mo post-treatment, BCVA(LogMAR)was improved, CMT was decreased, the length of DRIL was shortened, the number of HRD was reduced, the area of IRF was decreased, the area of SRF was reduced, and the length of EZ disruption was shortened(all P<0.05). Spearman correlation analysis showed that there was no correlation between the changes in CMT, the length of DRIL, the number of HRD, the area of IRF, the area of SRF and the change in BCVA before and after treatment(P>0.05). However, the change in the length of EZ disruption was positively correlated with the change in BCVA(rs=0.34, P=0.011), and the R2 value of the fitting curve between the change in the length of EZ disruption and the change in BCVA was 0.113(P=0.011). When comparing the pre- and post-treatment changes in BCVA, the length of DRIL, the number of HRD, the area of IRF, the area of SRF, and the length of EZ disruption between patients in the CRVO group and BRVO group, no significant differences were observed(all P>0.05). In contrast, a significant difference was found in the change in CMT between the two groups(P=0.002).CONCLUSION:Conbercept effectively improves multiple OCT biomarkers in patients with RVO-ME. Repair of EZ disruption is a key driver of visual recovery, and its stability may serve as a novel indicator for personalized decision-making in anti-vascular endothelial growth factor therapy.

安徽省卫生健康科研项目(No.AHWJ2024BAa20031,AHWJ2022c021)