目的 观察康柏西普玻璃体腔注射治疗湿性老年性黄斑变性病变对于视网膜神经纤维厚度的影响。方法 对2016年10月—2017年10月在汕头大学附属韶关市粤北人民医院采用康柏西普玻璃体腔注射治疗湿性老年性黄斑变性35例38眼中符合标准的患者18例（18眼）的临床资料进行回顾性分析,患者行最佳矫正视力、眼压（NCT）检查、OCT、荧光眼底血管造影（FFA）检查后,均接受0.05 mL康柏西普玻璃体腔注射,分别注射后1和2月观察患者最佳矫正视力 （BCVA）、视网膜神经纤维厚度（RNFL）变化。结果 18眼共接受康柏西普玻璃体腔注射54次,所有患眼均注射3次。注射3个月后,OCT检查结果显示有18眼视力有提高,CRT厚度有下降。第1次注射时和注射后1个月、2个月的BCVA分别为0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）,总体比较差异有统计学意义（χ²=13.880,P<0.001）;第1次注射时和注射后1个月、2个月的CRT（μm） 319.50（269.50,390.50）, 271.00（219.00,296.25） 和234.50（182.75,273.25）总体比较差异有统计学意义（χ²=11.978,P<0.05）,第1次注射时和注射后1个月、2个月后的 ARNFL（μm）86.00（76.25,98.00） 83.00（76.00,95.50）和 83.00（76.25,94.75） 总体比较差异无统计学意义（χ²=11.978,P>0.05）,第1次注射时和注射后1个月、2个月眼压（kPa）2.27（1.97,2.44）,16.0（13.7,17.0）,和 2.00（1.84,2.31） 总体比较差异无统计学意义（χ²=1.604,P>0.05）。结论 玻璃体腔注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度无明显的损害,安全且有效,但仍需要大样本量及长期随访观察。

Objective To observe the effect on the thickness of retinal nerve fibers in the patients with wet age-related macular degeneration by adopted intravitreal injection with Conbercept. Methods We analyzed 18 cases （18 eyes） that conform to the standard from 35 cases（38 eyes） retrospectively,who were treated with wet age-related macular degeneration by adopted intravitreal injection with Conbercept in Shaoguan Yuebei People's Hospital Affiliated to Shantou University from October in 2016 to October in 2017.After undergoing best corrected visual acuity （BCVA）,intraocular pressure （IOP） and fluorescein angiography （FFA）,all of them were adopted intravitreal injection with 0.05mL Conbercept. We observed the changes of best corrected visual acuity （BCVA） and retinal nerve fiber thickness （RNFL） after 1 and 2 months of adopted intravitreal injection with 0.05 mL Conbercept. Results 18 eyes were adopted intravitreal injection Conbercept 54 times totally. All the eyes were injected three times. After 3 months of injection,OCT showed that the visual acuity of 18 eyes improved and the thickness of CRT decreased. The BCVA values at the first injection,after the first injection and after the second injection were 0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）respectively. The overall difference was statistically significant （χ²=13.880,P< 0.001）. CRT（μm）values at the first injection,after the first injection and after the second injection were 319.50（269.50,390.50）,271.00（219.00,296.25） and 234.50（182.75,273.25）respectively. The overall difference was statistically significant （χ²=11.978,P< 0.05）. ARNFL（μm）values at the first injection,after the first injection and after the second injection were 86.00（76.25,98.00）,83.00（76.00,95.50） and 83.00（76.25,94.75）respectively. There was no significant difference （χ²=11.978,P> 0.05）. The IOP（mmHg）values at the first injection,after the first injection and after the second injection were 17.0（14.8,18.3）,16.0（13.7,17.0）,和 15.0（13.8,17.3）respectively. There was no significant difference（χ²=1.604,P>0.05）. Conclusion There was no obvious damage to the retinal nerve fiber by adopted intravitreal injection with Conbercept to treat the patients with wet age-related macular degeneration. That’s safe and effective,but need a large sample to follow-up for a longtime.

       目的   针对目前常规使用的玻璃体腔注射针头容易引起注射后小鼠眼内出血和损伤晶状体的缺陷，本研究采用直径仅0.08 mm的玻璃毛细管作为实验用小鼠眼内注射针头进行玻璃体腔注射，并评估其安全性和可行性。方法  选取12只6-8周的C57BL/6J雄性小鼠，左眼注射磷酸盐缓冲液为实验组，右眼不做特殊处理为对照组。6只小鼠玻璃体腔注射后立即腹腔注射伊文思蓝，检测视网膜血管渗漏情况；另外6只小鼠玻璃体腔注射后24 h处死，视网膜铺片免疫荧光染色小胶质细胞特异性抗体抗离子钙接头蛋白1，分析小胶质细胞的形态变化。结果  实验组和对照组血管与周围荧光强度比值分别为（4.45±0.30）和（4.51±0.24），小胶质细胞数量分别为（131.00±5.38）个/mm2 和（133.00±5.99）个/mm2 ，小胶质细胞胞体面积分别为34.02（27.82，40.54）μm2 和34.70（26.09，40.54）μm2 ，小胶质细胞分支长度分别为198.80（171.30，258.80）μm和223.30（178.20，278.30）μm，两组相比差异均无统计学意义（均P＞0.05）。结论   经改良的玻璃毛细管直径更细，损伤更小，可以替代传统的注射针头，可作为实验用小鼠眼内注射针头进行玻璃体腔注射。

       Objective  To assess the safety and feasibility of employing an enhanced glass capillary，with a diameter of 0.08 mm，as an intraocular needle for intravitreal injections in experimental mice eyes．Methods  Twelve male C57BL/6J mice，aged 6-8 weeks，were utilized in this investigation．Phosphate buffered saline（PBS）was administered via intravitreal injection into the left eye of each mouse（experimental group），while the right eye received no special treatment（control group）．Six mice received an intraperitoneal injection of Evans blue immediately following intravitreal injection to detect retinal vessel leakage．The remaining six mice were euthanized 24 hours after intravitreal injection，and the retinas were subjected to immunofluorescence staining using a microglia-specific antibody to analyze morphological changes in microglia．Results  In both the experimental and control groups，the ratio of vascular to peripheral fluorescence intensity was（4.45±0.30）and（4.51±0.24），respectively．The number of microglia was（131.00±5.38）/mm2  and（133.00±5.99）/mm2 ，the cell body area of microglia was 34.02（27.82，40.54）μm2  and 34.70（26.09，40.54）μm2 ，and the branch length of microglia was 198.80（171.30，258.80）μm and 223.30（178.20，278.30）μm，respectively．There were no statistically differences observed in any of the above indicators between the two groups（all P＞0.05）．Conclusions  The use of this glass capillary，characterized by a narrower diameter，reduces tissue damage，demonstrates its potential to replace traditional injection needles for performing intravitreal injections in experimental mice．