| Purpose: Compare the baseline characteristics and the efficacy of intravitreal anti-vascular endothelial growth factor(anti-VEGF)treatment between young patients(<55 years old)and elderly patients(≥55 years old)with central retinal vein occlusion(CRVO),and to evaluate the related factors affecting the vision prognosis.Methods: The subjects were 44 patients with macular edema(ME)secondary to CRVO diagnosed in the ophthalmology department of the First Affiliated Hospital of China Medical University from September 2018 to September 2022,including 19 eyes in the young group and 25 eyes in the elderly group.It was a retrospective case-control study.All patients were treated with intravitreal anti-VEGF treatment with 3+PRN injection.Gender,age,eye type,intraocular pressure(IOP),course of disease before the first injection,combination of traditional risk factors,and injection times were collected.Best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)indexes were recorded at baseline and each point after treatment(1,3,6,and 12 months after initial injection)which included: central retinal thickness(CRT),subfoveal choroidal thickness(SFCT),external limiting membrane/ellipsoid zone(ELM/EZ)interruption length within 1mm scanning range of macular fovea,hyperreflective foci(HF)quantity within 4mm scanning range of macular fovea and the presence of subretinal fluid(SRF).SPSS statistical software was used to conduct intra-group and inter-group studies on each index of the two groups,and to analyze the baseline factors affecting the vision prognosis.Results: 1.Comparison of baseline data between the two groups: Compared with the elderly group,higher proportion of male,better baseline vision,thinner baseline CRT,thicker baseline SFCT,more baseline HF quantity,less proportion of SRF existed in the young group(P < 0.05).There were no significant differences in eye type difference,course of disease before the first injection,proportion of hypertension,proportion of diabetes,proportion of hyperlipidemia,baseline IOP and baseline ELM/EZ interruption length between the two groups(P > 0.05).2.Comparison of efficacy after anti-VEGF treatment between the two groups: indexes in the two groups changed after treatment,namely compared with baseline indexes,BCVA(Log MAR)improved;CRT and SFCT decreased;ELM/EZ integrity improved;HF quantity decreased;SRF absorbed.There were statistically significant differences in rangeability of CRT and HF quantity between the two group(P<0.05).The rangeability of CRT is higher in the elderly group and the rangeability of HF is higher in the young group,while there were no statistically significant differences in rangeability of BCVA(Log MAR),SFCT,ELM/EZ interruption length and SRF between the two groups(P>0.05).3.Baseline indexes associated with12 mo BCVA(Log MAR)in the young group included age,BCVA(Log MAR),and ELM/EZ interruption length;Baseline indexes associated with 12 mo BCVA(Log MAR)in the elderly group included age,BCVA(Log MAR),ELM/EZ interruption length,and HF quantity.Multiple linear regression analysis showed that baseline BCVA(Log MAR)was a significant predictor of terminal visual acuity(P<0.05).4.There were no serious ocular and systemic complications after treatment in the two groups,and the difference of injection times between the two groups was statistically significant(4.42±1.02vs5.56±1.61)(P<0.05).Conclusions: 1.Anti-VEGF treatment can effectively treat CRVO-ME at different ages,improve visual acuity and retinal microanatomy structure,with good safety.2.The young group had better baseline vision and terminal vision.3.OCT indexes were different in CRVO patients at different ages,and the damage of retinal microanatomical structure was less in young patients.4.Age,baseline visual acuity,baseline ELM/EZ interruption length were correlated with the prognosis of vision,and baseline visual acuity was an important predictor of vision prognosis. |
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