Real World Study Of Ranibizumab In The Treatment Of Macular Edema Caused By Branch Retinal Vein Occlusion

Objective:To observe the efficacy of different treatment schemes of razumab in patients with branch retinal vein obstructive macular edema.Methods: 40 patients(41 eyes)with branch retinal vein obstructive macular edema were treated in the outpatient department of Inner Mongolia forestry general hospital from January 1,2019 to December 31,2021.No control group was established.All patients voluntarily received anti VEGF treatment,and the anti VEGF drug was leizumab injection.The central retinal thickness(CRT)> 250 um is the indication of intravesical injection of leizumab.Whether to receive anti VEGF treatment fully respects the wishes of patients.Regular anti VEGF treatment,3 needles or 3 + PRN in 22 cases(23 eyes),5 needles or 5 +PRN in 15 cases(15 eyes),6 needles or 6 + PRN in 3 cases(3 eyes).The average follow-up time was 25.7 weeks.This study was carried out with the approval of the ethics committee of the eye hospital of Inner Mongolia Forestry General Hospital,which is in line with the principles of the Helsinki declaration.The medical records of all patients were complete,including the patient’s name,gender,age and past medical history.Informed consent was signed for each injection.All patients were examined by ordinary far vision,non-contact intraocular pressure measurement,fundus photography and Heidelberg optical coherence tomography OCT(spectral domain OCT,SD-OCT or Fourier domain OCT,FD-OCT).Based on the characteristics of OCT,this study analyzed the changes of CRT and visual acuity in patients with branch retinal vein obstructive macular edema after continuous injection of leizumab.SPSS 20.0(SPSS Inc.,Chicago,USA)software was used for statistical analysis.The measurement data are statistically described by(x ± SD),the single sample K-S goodness of fit method is used for the normality test,and the analysis of variance is used for the comparison between multiple groups of means subject to normal distribution.Results: the improvement of visual acuity after receiving 5 needles + PRN was significantly better than that of 3 needles + PRN(P < 0.05);After receiving 5 needles +PRN,the decrease of CRT was significantly better than that of 3 needles + PRN(P < 0.05);There was no significant difference in age,sex and intraocular pressure(P > 0.05);There was no significant difference in the improvement of visual acuity between 6 needles + PRN and 5 needles + PRN / 3 needles + PRN(P > 0.05);The change of CRT thickness after receiving 6 needles + PRN treatment was statistically significant as that of 5 needles +PRN / 3 needles + PRN treatment(P < 0.05);The average follow-up was 25.7 weeks.Two patients with 3 needles recurred and were treated with PRN;There was no recurrence in 5and 6 needles;SD-OCT was used to display the changes of retinal ten layer structure curve,combined with OCT characteristic biomarkers to predict the prognosis,visual acuity and injection times.Conclusion: the patients with BRVO in Hulunbuir,Inner Mongolia who received 5-needle regular anti VEGF treatment had the greatest visual benefit(> 3-needle + PRN,BCVA value after 6-needle + PRN P > 0.05),and the average CRT decreased to the normal range after 5-needle treatment;Within the average follow-up time,the recurrence rate of patients was 8.7% for 3 needles,0% for 5 needles and 6 needles;The thickness of CRT after receiving 6 needles + PRN was higher than that after receiving 5 needles + PRN;Using SD-OCT to analyze the fluctuation of retinal ten layer lines and OCT characteristic biomarkers in patients with BRVO with macular edema can predict the prognosis and visual acuity and provide individualized treatment.