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当前位置：国际临床研究杂志 > 2026年 10卷 (9)期

Open Access Article

International Journal of Clinical Research. 2026; 10: (9) ; 58-61 ; DOI: 10.12208/j.ijcr.20260437.

A paradigm shift in the treatment of macular edema secondary to retinal vein occlusion: From single-target anti-VEGF therapy to multi-target combination therapy
视网膜静脉阻塞继发黄斑水肿的治疗范式转换——从抗VEGF治疗走向联合干预

作者： 王重重^1,2, 张琼², 李新章² *

1青海大学临床医学院青海西宁

2青海红十字医院青海西宁

*通讯作者：李新章,单位：青海红十字医院青海西宁；

发布时间: 2026-09-10 总浏览量: 7 下载量: 加载中...

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摘要

视网膜静脉阻塞继发的黄斑水肿（RVO-ME）是临床上导致视力严重受损的主要病因之一。以往治疗多围绕抗血管内皮生长因子（VEGF）单靶点药物展开，但近半数患者需要频繁眼内注射才能稳住病情，同时该疗法仅针对单一通路，无法干预多重病理损伤。随着相关发病机制研究不断完善，临床治疗思路不再局限于单纯抗VEGF，而是采用多靶点联合方案。当前策略以上游抗氧化、中游抗炎、下游抗VEGF的分层协同为核心，辅以阈值下微脉冲激光光凝（sMLP）激光及中药活血化瘀疗法。临床证据表明联合方案可改善视力、减少注射频次，但需警惕眼压升高、白内障进展等不良反应。未来更趋向个体化治疗，建立贯穿疾病全程的治疗模式。

关键词： 视网膜静脉阻塞；黄斑水肿；联合治疗

Abstract

Macular edema secondary to retinal vein occlusion (RVO-ME) is one of the leading causes of severe vision loss in clinical practice. Previous treatments have primarily focused on single-target anti-Vascular Endothelial Growth Factor (VEGF) agents; however, nearly half of patients require frequent intravitreal injections to stabilize their condition. Furthermore, this therapy targets only a single pathway and cannot address multiple pathological lesions. As research into the underlying mechanisms continues to advance, clinical treatment strategies are no longer limited to anti-VEGF therapy alone but now incorporate multi-target combination regimens. The current strategy centers on a tiered, synergistic approach-upstream antioxidant therapy, midstream anti-inflammatory therapy, and downstream anti-VEGF therapy-supplemented by Subthreshold Micropulse Laser Photocoagulation (sMLP) laser treatment and traditional Chinese medicine therapies to promote blood circulation and dispel blood stasis. Clinical evidence indicates that this combination regimen can improve visual acuity and reduce the frequency of injections; however, caution is warranted regarding adverse reactions such as elevated intraocular pressure and cataract progression. Future treatment will increasingly trend toward personalized care, establishing a treatment model that spans the entire course of the disease.

Key words： Retinal vein occlusion; Macular edema; Combination therapy

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引用本文

王重重, 张琼, 李新章, 视网膜静脉阻塞继发黄斑水肿的治疗范式转换——从抗VEGF治疗走向联合干预[J]. 国际临床研究杂志, 2026; 10: (9) : 58-61.

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