The Effect Of Treatment Of Macular Edema Caused By Retinal Central Vein Occlusion With Avastin

Objective:Central retinal vein occlusion (CRVO) is a common clinical blinding retinal disease. Macular edema(ME) is the common complications of this disease and is one of the major vision loss cause. The commonly used treatment, including laser grid pattern photocoagulation therapy, intravitreal injection of triamcinolone acetonide. Laser photocoagulation treatment: Although we have been in clinical use of laser grid photocoagulation in treatment of cystoid macular edema or diffuse macular edema, central retinal vein occlusion, however, according to research group (CVOS) multi-center study: the treatment group compared with non- than the laser grid pattern photocoagulation visual acuity showed no significant group differences. Triamcinolone acetonide (TA) is a glucocorticoid, has many biological effects, the primary purpose is to stabilize the blood - retina barrier, re-absorption of exudate and reduced inflammatory stimulation,in the clinical treatment of macular edema achieved certain results. Intravitreal injection of TA problems are: 1. Need to repeat injections; 2. Intraocular pressure; 3. Complicated cataract; 4. Endophthalmitis and retinal detachment.There are a large number of studies show that vascular endothelial growth factor (VEGF) is not only a potential angiogenesis stimuli, and can lead to vascular leakage.Vascular endothelial growth factor in vascular permeability increase in the incidence of macular edema, which plays an important role. Anti-VEGF drugs to the role of targeting VEGF or its receptors in the signaling pathway, thereby increasing vascular permeability caused by the treatment of macular edema. Bevacizumab (trade name Avastin) is a humanized recombinant anti-VEGF mouse monoclonal antibody, VEGF has two binding sites, the ability to combine all with the activity of VEGF, VEGF-A for all the active type. Avastin is widely used in recent years of neovascular eye diseases and shows encouraging efficacy,initial clinical application found few side effects, easier to implement.In this study, to discuss the safety and effect of intravitreal injection of bevacizumab (Avastin) on the central retinal vein occlusion macular edema. Purpose of observation of the central retinal vein occlusion Avastin for macular edema due to treatment, and through the establishment of the control group compared with triamcinolone acetonide and explore its advantages and disadvantages. Based search for effective treatment of the disease, few side effects of treatment.Methods:40 cases of such patient were divided into two groups randomly. Experimental group, 20 cases of vitreous injection of Avastin, with a 1ml disposable syringe, in the temporal limbal below 4mm Department after the injection of 0.05ml (containing 1.25mg) Avastin. Control group, 20 cases of intravitreal injection of triamcinolone acetonide (TA), with a 1ml disposable syringe, in the temporal limbal below 4mm Department after the injection of 0.1ml (containing 4mg) TA, maintain the seat at least 2h, in order to prevent drug particles deposited in the macular area. Before and after treatment were best corrected visual acuity, slit lamp, fundus, intraocular pressure, FFA, mf-ERG and OCT examination. Follow-up period of 6 months.Results:Experimental group after 1 month, 3 months, 6 months, visual acuity, respectively (0.274±0.206), (0.335±0.254), (0.372±0.289), and before treatment (0.226±0.176) were statistically compared A Difference (t value was -3.540, -5.215, -5.868, P values were 0.002,0.000,0.000). After 1 month, 3 months, 6 months, retinal thickness was (503.45±167.304μm), (357.90±156.630μm), (303.15±147.056μm), and before treatment (657.85±189.492μm) were compared a significant difference (t values were 7.928,9.406,9.768, P = 0.000). The experimental group after 1 month, 3 months, 6 months compared with the average preoperative IOP was no significant change, the difference was not statistically significant (t values were 1.738,2.803,1.867, P value> 0.05). The control group after 1 month, 3 months, 6 months, visual acuity, respectively (0.295±0.252), (0.355±0.242), (0.301±0.222), and before treatment (0.225±0.171) were statistically compared A Difference (t value was -2.904, -4.421, -3.179, P values were <0.05). After 1 month, 3 months, 6 months, retinal thickness was (500.35±161.893μm), (393.30±180.757μm), (373.55±187.332μm), and preoperative (646.95±172.435μm) were compared a significant difference (t values were 5.924,7.167,6.675, P = 0.000). The control group after 1 month, 3 months, 6 months, mean IOP were improved, the difference was significant (t value was -3.350, -2.169, -2.304, P values were <0.05). Experimental group after 1 month, 3 months, 6 months and the control group at corresponding time points, visual acuity, OCT was statistically no difference between the value of comparison (P values were> 0.05). The experimental group during the observation period without high intraocular pressure, cataract, retinal detachment, complications of intraocular go far. Control group, 7 cases in the observation of high intraocular pressure during the case, but not cataract, retinal detachment, complications of intraocular go far.Conclusion:Avastin is a safe and effective method of treatment of ME due to CRVO, short-term effect of significantly more secure than with TA. The drawbacks of this experiment samples of small amount for short period, they need more long-term observation of a large sample to determine its efficacy and superiority over TA.