Clinical Efficacy Of Intravitreal Dexamethasone Implant(Ozurdex)Combined With Compound Xueshuantong Capsule In The Treatment Of RVO-ME

Purpose:To observe the microvascular structure changes in retinal vein occlusion(RVO)as well as evaluate the clinical effect of intravitreal dexamethasone implant(IDI)combined with compound xueshuantong capsule(CXC)in the treatment of macular edema associated with RVO.Method:Prospective study.A total of 31 cases with macular edema secondary to RVO(RVO group)and 31 healthy subjects(control group)were enrolled into this study.The RVO group was divided into two subgroups:① IDI group(16 eyes):treated with single dexamethasone intravitreal implant;②Combination group(15 eyes):treated with IDI combined with CXC(1.5g/time,3 times/day).The foveal avascular zone(FAZ),superficial capillary plexus density(SCPD),deep capillary plexus density(DCPD)and choriocapillaris flow area(CFA)of healthy subjects and RVO patients were detected using OCTA at baseline and 1,2,3 months post injection.Best corrected visual acuity(BCVA),intraocular pressure(IOP),central macular thickness(CMT)and adverse effects were also evaluated in all of them.Results:A statistically significant difference between the two groups(RVO and control)was found in terms of CMT、SCPD、DCPD and CFA(P<0.01).FAZ had no significant difference(P>0.05).Patients were followed up for 3 months after injection.In the two subgroups(IDI and Combination group),BCVA、CFA were significant increased and CMT were significant decreased as well as FAZ、SCPD、DCPD had no significant difference at follow-up.Compared with IDI group,there was no significant difference in BCVA、CMT、FAZ、SCPD and DCPD(P>0.05),but the CFA at 3 month post injection in Combination group was better,the differences was statistically significant(P<0.05).Correlation analysis showed BCVA was significantly correlated with both CMT and CFA,but there was no correlated with FAZ,SCPD and DCPD.In the IDI and Combination groups,intraocular pressure increased significantly in 5 and 3 patients respectively,as well as 1 and 2 patients showed cataract progression,respectively.Conclusion:IDI can effectively reduce CMT and improve BCVA of the patients with RVO-ME.It has longer duration of curative effect and favorable safety profile.Compared with the IDI group,IDI combined with CXC has certain advantages in reducing macular edema and improving choroidal blood flow.