| Objective:To analyze the relationship between the initial signs and age of macular edema(ME)and the effect of vitreous injection of razumab in the treatment of macular edema(ME)secondary to branch retinal vein occlusion(BRVO),so as to provide clinical basis for predicting the therapeutic effect and judging the prognosis.Methods:In this study,40 patients with macular edema caused by branch retinal vein occlusion and intravitreous injection of razumab were selected from January 2019to January 2021.Macular edema occurred within one month after diagnosis.The initial best corrected visual acuity(BCVA)was evaluated and recorded at the time of diagnosis.BCVA was converted into logarithm of the minimal angle of resolution(Log MAR),whether it was main branch obstruction,the distance between fovea and occlusion,macular thickness,type of macular edema,macular hemorrhage and capillary non-perfusion and other physical factors.After diagnosis,patients received intravitreal injection of razumab,which was treated as needed after one injection of1+PRN was found,and was injected again when macular edema relapsed and visual acuity deteriorated.No reinjection rate was evaluated within 1 year after the first injection(no reinjection rate was considered to be the survival rate),and the correlation between various physical signs and ME recurrence was evaluated,and the related influencing factors were determined to predict the prognosis.Results:1.Comparison of general data and baseline characteristics of related factors in the distribution of multiple intravitreal injection of ranibizumab(Intravitreal Injection Of Ranibizumab,IVR)group and single IVR group,the results show:age(Z=2.014,P=0.045),average visual acuity(Z=2.163,P=0.032),distance between obstruction location and fovea(T=3.327,P=0.002),whether the main branch is obstructed(X~2=10.566,P=0.001),follow-up time(T=13.365,P<0.001)there is a statistical difference.It shows that the above factors are related to the grouping.2.According to the results of the baseline data,in order to understand the relationship between the number of injections and influencing factors,Spearman correlation analysis was applied.The results showed that the variables that were significantly related to the number of injections during the follow-up period were age(R=0.394,P=0.012),main branch obstruction(R=0.441,P=0.004),average visual acuity(R=0.346,P=0.029),distance between obstruction position and fovea(R=0.516,P=0.001),indicating age,vision,distance between obstruction position and fovea,And whether the main branch is blocked is related to the number of injections.The correlation between other variables and the number of injections in 1 year was not statistically significant.3.According to the general clinical data and the results of Spearman correlation analysis,we included preoperative≤Log MAR0.5 as high vision group,visual acuity>Log MAR0.5 as low vision group,obstruction location and fovea distance into two groups,<2.5DD as one group,≥2.5DD as one group,trunk branch obstruction into two groups,trunk branch obstruction into one group,and others into one group.Different factors and survival rates were compared between the two groups.The results showed that the survival rate of visual acuity≤Log MAR0.5,was 53.6%,and the survival rate of visual acuity>Log MAR0.5,was 16.7%(p<0.04).The distance between the obstruction site and the fovea was less than 2.5DD,and the survival rate was 72.2%.The distance between the obstruction location and the fovea was≥2.5DD,and the survival rate was 18.2%(p<0.01).The survival rate of no trunk branch obstruction was 66.7%,and the survival rate of trunk branch obstruction was 15.8%(p<0.01),indicating that the recurrence rate of low vision group was high,the recurrence rate of obstruction location≥2.5DD was high,and the recurrence rate of trunk branch obstruction was high.4.Regression analysis confirmed that several influencing factors were indeed related to the risk of recurrence.Age,distance between obstruction location and fovea,trunk branch obstruction were statistically significant.Increased age(OR=1.084,95%CI:1.003-1.172),obstruction location and fovea distance≥2.5DD(OR=8.711,95%CI:1.181-64.234),trunk branch obstruction(OR=19.897,95%CI:2.053-192.788)were risk factors for recurrence.Conclusion:In patients with BRVO-ME,risk factors for recurrence included age,distance between obstruction location and fovea,trunk branch obstruction and initial visual acuity.The probability of repeated vitreous injection of razumab due to macular edema is lower in BRVO-ME patients with one of the factors such as younger age,less than 0.5Log MAR visual acuity at first visit,proximity of occlusive vein to the center of retinal fovea and involvement of small macular branches at first diagnosis. |
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