| Objective:To observe the changes of morphological structure and function of the macular edema(ME)after intravitreal injection Conbercept(IVC)treatment of branch retinal vein occlusion(BRVO)and the correlation between them to evaluate the efficacy and analyze the factors affecting prognosis,and explore new indicators for prognosis evaluationMethods:This experimental design uses prospective research methods.A total of 96 eyes(96 eyes)of patients with secondary macular edema who were diagnosed with branch retinal vein occlusion and voluntarily received IVC treatment from the Department of Ophthalmology,the affiliated Hospital of Zunyi Medical University from October 2017 to November 2018 were collected.All patients were treated with the "3+PRN" regimen by intravitreal injection of Conbercept 0.05mL/0.5mg.Record the best corrected visual acuity(BCVA)before treatment,1,3,and 6M after treatment(checked with international standard vision chart and converted to LogMAR BCVA record),central macular thickness(CMT),the rupture length of the ellipsoid zone,the rupture length of external limiting membrane,multifocal electroretinogram(mf-ERG)first-order function 1-6 rings P1 wave,N1 wave amplitude density and latency data and other data.The changes of each observation index before and after treatment were analyzed by repeated measurement analysis of variance.The correlation analysis of macular morphology index,function index and best corrected visual acuity before treatment was Pearson correlation analysis,and the prognostic factors were analyzed by multiple linear regression analysisResults:1.Changes in various indicators before and after treatment Compared with the untreated,96 cases of 96 eyes increased the LogMAR BCVA,N1 and P1 wave amplitude density of 1-2 rings at 1 month,3 months,and 6 months(P<0.001).The CMT,the rupture length of the ellipsoid zone and the rupture length of external limiting membrane were decreased(P<0.001),but the amplitude density of the N1 and P1 waves in 3-6 rings and the latency of the N1 and P1 waves in 1-6 rings did not change significantly(P>0.05).2.Univariate correlation analysis of main parameters of LogMAR BCVA,SD-OCT and mf-ERG after treatmentSix months after treatment,LogMAR BCVA was not correlated with pre-treatment CMT(P>0.05),and was positively correlated with the length of the ellipsoidal band before treatment(r=0.671,P<0.05),and was positively correlated with the ellipsoidal band break length before treatment(r=0.696,P<0.05),which was negatively correlated with the P1 wave amplitude density of the 1 ring before treatment(r=-0.679,P<0.05),and negatively correlated with the P1 wave amplitude density of the 2 ring before treatment(r=-0.618,P<0.05),and it was not related to the P1 wave amplitude density of 3-6 rings before treatment,the N1 wave amplitude density of 1-6 rings before treatment,the N1-P1 wave latency of 1-6 rings before treatment(P>0.05);CMT was negatively correlated with the P1 wave amplitude density of the 1 ring before treatment(r=-0.619,P<0.05),and negatively correlated with the P1 wave amplitude density of the 2 ring before treatment(r=-0.674,P<0.05).3.Influencing factors of BCVA prognosis after BRVO secondary to MEMultivariate analysis results showed that LogMAR BCVA’s prognostic factors were LogMAR BCVA before treatment(t=0.346,P=0.001),ellipsoidal band break length before treatment(t=0.107,P=0.037),and external membrane rupture length before treatment(t=0.025,P=0.021),P1 wave amplitude density of 1 ring before treatment(t=-0.054,P=0.024),P1 wave amplitude density of 2 ring before treatment(t=-0.038,P=0.008)and treatment 6 month later,the P1 wave amplitude density of 1 ring(t=-0.035,P=0.014).Subconjunctival hemorrhage occurred in 5 cases and 5 eyes after injection,and all returned to normal after treatment.No severe complication occurred in all patients during treatment and follow-up.Such as secondary glaucoma,vitreous hemorrhage,retinal detachment,acute retinal necrosis,etc.Conclusion:1.Intravitreal injection of Conbercept in the treatment of BRVO secondary ME has a short term effect,which can improve vision to a certain extent and restore retinal structure and function;2.After treatment,the changes in mf-ERG are mainly based on the increase in amplitude density.Among them,the N1 and P1 waves of 1-2 rings have changed significantly,and the other 3-6 rings have no significant improvement;3.The better the vision before treatment,the shorter the ellipsoidal band break length and the outer membrane break length,the higher the P1 wave amplitude density of 1-2 rings,and the higher the P1 wave amplitude density of 1 ring at 6 months after treatment,the better the vision prognosis. |
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