| Purpose:To observe and analyze the clinical efficacy and safety of anti-vascular endothelial growth factor(VEGF)treatment to patients with macular edema(ME)secondary to reinal vein occlusion(RVO).Method:Retrospective analysis of 155 patients(155 eyes)with macular edema secondary to RVO in the second hospital of Jilin University from June,2015 to September,2016,including 67patients(67eyes)with retinal central retinal vein occlusion(CRVO)and 88 patients(88 eyes)with branch retinal vein occlusion.CRVO and BRVO patients were divided into experimental group and control group according to random number method:CRVO experimental group includes 34 cases(34 eyes)and 33 cases(33 eyes)in control group;BRVO experimental group includes 44 cases(44eyes)and 44 cases(44 eyes)in control group.The patients in the experimental groups accepted intravitreal anti-VEGF treatment once or more times in the second hospital of Jilin University and were given the treatment of Extract of Ginkgo Biloba Leaves Tablets and Calcium Dobesilate Capsules.The control group were treated with the treatment of Extract of Ginkgo Biloba Leaves Tablets and Calcium Dobesilate Capsules.Preoperative examination included best corrected visual acuity(BCVA),fluorescein angiography(FFA),optical coherence temography(OCT).Indicators such as intraocular pressure(IOP),BCVA,central macular thickness(CMT),3mm maximum thickness around macular fovea and the occurrence of complications were observed before and after treatment(1w,1m,3m,6m)in the experimental group and the control group.Results:①BCVA:In CRVO experimental group,1w,1m,3m,6m BCVA((Logarithm of the minimum angel of resolution,logMAR)values were 0.78±0.66,0.57±0.15,0.50±0.23,0.55±0.11,before and after treatment showed significant differences(P<0.05).Compared with lm,3m and 6m after treatment,results in 1w showed the difference was statistically significant(P<0.05).There was no significant difference between 1m,3m and 6m after treatment(P>0.05).In the control group,the BCVA(logMAR)values of 1w,3m,6m were 1.05±0.23,1.01±0.18,0.99±0.47,1.02±0.19.Compared with before treatment,the mean value fluctuated slightly but showed no significant difference(P>0.05).There was no significant difference in BCVA(logMAR)between every follow-up points(P>0.05).There was significant difference in BCVA after treatment between experimental group and the control group at the time of follow-up(P<0.01).In BRVO experimental group,1w,1m,3m,6m BCVA(logMAR)values were 0.79±0.26、0.42±0.95、0.43±0.67、0.40±0.58,before and after treatment showed significant differences(P<0.05).Compared with lm,3m and 6m after treatment,results in 1w showed the difference was statistically significant(P<0.05).There was no significant difference between 1m,3m and 6m after treatment(P>0.05).In the control group,the BCVA(logMAR)values of 1w,3m,6m were 0.65±0.02、0.62±0.11、0.63±0.19、0.64±0.11.Compared with before treatment,the mean value showed no significant difference(P>0.05).There was no significant difference in BCVA(logMAR)between every follow-up points(P>0.05).There was significant difference in BCVA after treatment between experimental group and the control group at the time of follow-up(P<0.01).②CMT and 3 mm maximum thickness around macular fovea:The CMT and 3mm maximum thickness around macular fovea of CRVO trial group in the 1w,1m,3m,6m after treatment were:CMT:432.57±109.88μm,219.65±53.32μm,228.58±128.93 μm,298.84±138.44μm,and the 3mm maximum thickness around macular fovea:452.48±99.23μm,276.37±110.23μm,292.22±68.28μm,329.87±177.35μm.The differences between the two groups before and after treatment in all follow-up times were statistically significant(P<0.05).Compared with 1w after treatment,1m,3m,6m showed statistically significant difference(P<0.05).After treatment,1m,3m,6m were compared,the difference was not statistically significant(P>0.05).In the control group,the CMT and 3mm maximum thickness around macular fovea in the 1w,1m,3m,6m after treatment were:CMT:674.37±198.33μm、623.66±182.49μm、682.23±179.39μm、684.93±163.30μm,and the 3mm maximum thickness around macular fovea:695.24±110.59μm、699.66±123.47μm、688.21±124.02μm、699.46±167.23μm.Before and after treatment,there was no significant difference in the two indicators(P>0.05).There was no significant difference in the two indicators before and after treatment between experimental group and the control group at the time of follow-up(P>0.05)There was significant difference in the CMT and 3mm maximum thickness around macular fovea between the experimental group and the control group(P<0.01).In BRVO experimental group,the CMT and 3mm maximum thickness around macular fovea in the 1w,1m,3m,6m after treatment were:CMT:346.21±84.12μm、263.74±112.77μm、241.39±104.47μm、274.74±52.09μm,and the 3mm maximum thickness around macular fovea:384.73±55.73μm、299.72±73.05μm、287.18±102.02±m、310.21±94.20μm.The differences between the two groups before and after treatment in all follow-up times were statistically significant(P<0.05).lm,3m,6m after treatment showed no statistically significant difference(P>0.05).In the control group,the CMT and 3mm maximum thickness around macular fovea in the 1w,1m,3m,6m after treatment were:CMT:576.66±133.58μm、558.06±198.74μm、596.36±126.84μm、584.36±110.53μm,and the 3mm maximum thickness around macular fovea:617.23±103.34μm、625.47±88.45μm、632.05±111.32μm、656.00 ±194.48μm.Before and after treatment,there was no significant difference in the two indicators(P>0.05).There was no significant difference in the two indicators before and after treatment between experimental group and the control group at the time of follow-up(P>0.05)There was significant difference in the CMT and 3mm maximum thickness around macular fovea between the experimental group and the control group(P<0.01).③The occurrence of complications:Two cases of CRVO patients in the experimental group had a small amount of subconjunctival hemorrhage on the first day after treatment,and the bleeding was absorbed in one week.All patients had neither high intraocular pressure before and after treatment,nor the vitreous hemorrhage,retinal detachment,inflammation and other complications.Conclusion:Anti-VEGF drugs for the treatment of RVO-ME shows exact effect,can short-term promote macular edema absorption,and can significantly improve the patient’s vision.The long-term efficacy and repeat injection standards of intravitreal anti-VEGF treatment for the Retinal vein occlusion-macular edema(RVO-ME),still need a large sample RCTs and quality assessment analysis to illustrate. |
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