目的：探讨玻璃体腔内注射雷珠单抗(IVR)联合577 nm阈值下微脉冲激光(STML)治疗病理性近视继发脉络膜新生血管(PM-CNV)的临床疗效。

方法：选取2021年12月至2023年12月于包头市眼科医院就诊的PM-CNV患者52例52眼作为研究对象。采用数字抽签方式将患者按1：1随机分为两组：对照组(26眼)仅接受IVR治疗； 试验组(26眼)接受IVR-STML联合治疗。对比两组治疗前及治疗后3、6、9、12 mo最佳矫正视力(BCVA)、中心凹黄斑厚度(CMT)值和脉络膜新生血管(CNV)面积及IVR总次数的差异。

结果：两组患者治疗前一般资料具有可比性。与治疗前相比，治疗后3、6、9、12 mo，两组患者视力均改善，CMT均降低、CNV面积均减小(均P<0.05)； 试验组治疗3、6 mo CMT及治疗6、9、12 mo CNV面积明显低于对照组(均P<0.05)。治疗12 mo内，试验组平均IVR总次数明显低于对照组(P<0.05)。

结论：IVR单药治疗与IVR-STML联合治疗PM-CNV均能改善患者BCVA，且两组视力改善效果相当。IVR-STML联合治疗能更持久稳定地维持黄斑区解剖结构，有效抑制CNV病灶进展，并显著减少抗VEGF药物注射次数。该方案有助于减轻治疗负担、改善远期预后，具有显著临床优势。

METHODS: Totally 52 patients(52 eyes)who were diagnosed with PM-CNV at Baotou Eye Hospital from December 2021 to December 2023 were selected in the study. Patients were randomly assigned in a 1:1 ratio using digital randomization to two groups: control group(26 eyes)treated with IVR monotherapy, and experimental group(26 eyes)was treated with IVR-STML combined therapy. The best corrected visual acuity(BCVA), central macular thickness(CMT), CNV area, and total number of IVR were compared before treatment and at 3, 6, 9, and 12 mo after treatment.

RESULTS: The general data of the two groups before treatment were comparable. The BCVA was improved, CMT was decreased, and CNV area was reduced at 3, 6, 9, and 12 mo after the initial treatment(all P<0.05). The experimental group exhibited significantly lower CMT at 3 and 6 mo, and reduced CNV area at 6, 9, and 12 mo compared to the control group(all P<0.05). The average times of IVR in the experimental group was significantly less than that of the control group(P<0.05).

CONCLUSION:Both IVR monotherapy and IVR-STML combined therapy for PM-CNV can improve BCVA with comparable improvement. IVR-STML therapy offers durable macular stabilization, effectively controls CNV progression, and reduces anti-VEGF injections. It lowers treatment burden and improves long-term outcomes and is recommended as a preferred treatment strategy.