| Objective: To compare the clinical efficacy of ranibizumab combined with laser photocoagulation and ranibizumab alone in the treatment of macular edema secondary to branch retinal vein occlusion(BRVO-ME),and to analyze the factors affecting the prognosis of BRVO-ME patients.Methods: This study was a retrospective case-control study.A total of 87 patients with87 BRVO-ME diagnosed eyes admitted to our hospital from January 2020 to October2020 were included and divided into A group and B group.The A group was treated with ranibizumab combined with laser photocoagulation,and the B group was treated with ranibizumab alone.The best corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure(IOP)and the number of ranibizumab injections were compared between the two groups before treatment and at 1,3,6 and 12 months after treatment.The effective improvement of visual acuity was defined as BCVA at the end of follow-up increasing ≥2 lines from baseline,and the logistic regression analysis was used to analyze the factors affecting the effective improvement of visual acuity.Results: At each time point during the follow-up period,BCVA(Log MAR)in group A were 0.84±0.55,0.59±0.29,0.42±0.24,0.41±0.23,0.42±0.28,BCVA(Log MAR)in group B were 0.82±0.44,0.64±0.27,0.51±0.22,0.50±0.21 and 0.51±0.29,respectively.BCVA in both two groups were significantly improved at 1 and 3 months after treatment compared with the previous follow-up time point(P< 0.01),there was no significant difference at 6mo and 12 mo after treatment compared with the previous follow-up time point(P> 0.05).At each time point during the follow-up period,the CMT of group A were 584.13±93.84,343.98±61.80,259.68±44.78,248.09±38.33,252.55±38.37μm,the CMT of group B were 588.33±131.90,358.93±75.07,270.28±45.97,262.55±43.51,255.38±43.93μm,respectively.CMT in group A was significantly lower at 1mo,3mo and 6mo after treatment than that at the previous follow-up time point(P<0.01),CMT at12 mo after treatment was higher than that at 6mo after treatment(P<0.05);In group B,CMT was significantly lower at all time points after treatment than at the previous follow-up time point(P<0.05).There was no significant difference in BCVA and CMT between the two groups before and after treatment(P> 0.05).There was no difference in intraocular pressure of two groups before and after treatment,and the comparision intraocular pressure between the two groups at each time point in the follow-up period was no statistical significance(P> 0.05).The average number of ranibizumab injections in group A was 3.81±0.80,while in group B was 4.30±1.16.The comparison of the injection times of ranibizumab between the two groups was statistically significant(P<0.05).Of the 87 patients,65 had effective visual acuity improvement at final follow-up,disease course(OR=0.327,95%CI=0.112～0.961,P=0.042),baseline visual acuity(OR=0.128,95%CI=0.024～0.689,P=0.017),external limiting membrane(ELM)before treatment(OR=19.246,95%CI=1.846～200.618,P=0.013)and ellipsoid zone(EZ)before treatment(OR=17.919,95%CI=1.284～250.138,P=0.032)were factors affecting the effective improvement of BRVO-ME visual acuity.Conclusions: Ranibizumab is effective and safe in the treatment of BRVO-ME.Combination of laser photocoagulation do not lead to better functional and anatomical improvement,but reduce the number of ranibizumab injections.The course of disease,baseline visual acuity and the integrity of ELM and EZ before treatment are factors that influence the effective improvement of visual acuity in BRVO-ME patients. |
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