目的：观察玻璃体腔注射康柏西普治疗非缺血型视网膜静脉阻塞(RVO)继发黄斑水肿(ME)的临床效果。

方法：单中心回顾性研究。选取我院2023年1月至2024年3月期间收治的非缺血型ROV继发ME患者，根据阻塞部位不同分为视网膜中央静脉阻塞(CRVO)组和视网膜分支静脉阻塞(BRVO)组。所有患者均使用玻璃体腔注射康柏西普治疗每月1次，治疗3 mo。记录治疗前，治疗后(一个疗程3次注射完成)1、3、6 mo两组患眼最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、浅层毛细血管密度(SVD)、深层毛细血管密度(DVD)及黄斑中心凹无血管区(FAZ)面积。

结果：本研究共纳入非缺血型ROV继发ME患者120例128眼，根据阻塞部位不同分为CRVO组51例56眼(男31例，女20例，平均年龄61.39±10.32岁)和BRVO组69例72眼(男41例，女28例，平均年龄61.48±10.41岁)，两组患者治疗前一般资料比较均无差异(均P>0.05)。治疗后 1、3、6 mo，两组BCVA、CMT、SVD、DVD均较治疗前改善(均P<0.05)，BRVO组治疗后各时间BCVA优于 CRVO 组(均P<0.05)，两组间CMT、SVD、DVD比较均无差异(均P>0.05)； 治疗前后两组间FAZ面积比较均无差异(均P>0.05)。随访6 mo，两组患者并发症发生率比较无差异(均P>0.05)，复发率比较有差异(P<0.05)。

结论：玻璃体腔注射康柏西普治疗非缺血型CRVO和BRVO继发ME均有效，可改善视功能、减轻ME并修复视网膜结构与血流灌注； 但BRVO患者的视功能恢复及毛细血管密度改善更显著。

METHODS: Single center retrospective study. ME patients secondary to non-ischemic RVO admitted to the hospital from January 2023 to March 2024 were selected, and were divided into central retinal vein occlusion(CRVO)group and branch retinal vein occlusion(BRVO)group according to the location of obstruction. All patients were treated with intravitreal injection of conbercept once a month for 3 mo. The best corrected visual acuity(BCVA), macular foveal thickness(CMT), superficial capillary density(SVD), deep capillary density(DVD), and foveal avascular zone(FAZ)area were recorded before and after treatment(with 3 injections per course)at 1, 3, and 6 mo.

RESULTS:This study included a total of 120 ME secondary to non-ischemic RVO patients(128 eyes), who were divided into CRVO group(51 cases, 56 eyes, 31 males, 20 females, mean age 61.39±10.32 y)and BRVO group(69 cases, 72 eyes, 41 males, 28 females, mean age 61.48±10.41 y)based on the location of obstruction. There was no significant difference in general data between the two groups before treatment(both P>0.05). After 1, 3, and 6 mo of treatment, both groups showed improvement in BCVA, CMT, SVD, and DVD compared to before treatment(all P<0.05). BCVA in the BRVO group was better than that in the CRVO group at all time points after treatment(all P<0.05), while there was no difference in CMT, SVD, and DVD between the two groups(all P>0.05); There was no significant difference in FAZ area between the two groups before and after treatment(both P>0.05). Follow up for 6 mo showed no significant difference in the incidence of complications between the two groups of patients(both P>0.05), but there was a significant difference in the recurrence rate(P<0.05).

CONCLUSION: The first intravitreal injection of conbercept is effective in treating macular edema caused by non-ischemic CRVO and BRVO, improving visual function, reducing macular edema, and repairing retinal structure and blood flow perfusion. Notably, the recovery of visual function and improvement of capillary density are more significant in BRVO patients.