Clinical Observation On Traditional Chinese Medicine Combined With Intravitreous Injection Of Ranibizumab In Treatment For Macular Edema

Purpose:To objectivly evaluate the efficacy,safety and durability of traditional Chinese medicine combined with intravitreous injection with Ranibizumab(IVR) for the treatment of macular edema(ME),and the clinical observation provides the basis.Method:It is a retrospective and non-randomized clinical study.Thirty-eight cases(38eyes) of ME definitely diagnosed by Fluorescein Fundus Angiography(FFA) and Optical Coherence Tomography(OCT) are divied into simple injection treatment group(19eyes of19cases) and comprehensive treatment group(19eyes of19cases).The simple injection treatment group are treated with intravitreous injection with Ranibizumab0.5mg.The comprehensive group are treated with traditional Chinese medicine combined with intravitreous injection with Ranibizumab0.5mg.Followed up1-3months,intraocular pressure,manifestation of lens and fundus are observes. Moreover, best corrected visual acuity(BCVA) and central retinal thickness (CRT) are particularly observed between before injection and after injection at1w,1m,2m,3m.The efficacy of two therapies is evaluated by comparative analysis.Result:(1)Comparing LogMAR best corrected visual acuity(BCVA) at lw,lm,2m,3m of after treatment with it at treatment before,it is statistically significant in all two groups which illustrates BCVA is improved after treatment.But compareing the difficence of LogMAR BCVA between before and afer treatment at1w,1m,2m,3m in simple injection treatment with it in comprehensive treatment group, it is statistically significant at all four time pionts which illustrates comprehensive treatment could improve more BCVA.(2)Comparing CRT at1w,1m,2m,3m of after treatment with it at treatment before,it is statistically significant in all two groups which illustrates CRT is reduced after treatment.But compareing the difficence of CRT between before and afer treatment at lw,lm,2m,3m in simple injection treatment with it in comprehensive treatment group, it is statistically significant at all four time points which illustrates comprehensive treatment could reduce more CRT.(3)38patients receive57times injection with Ranibizumab in totle. There are2patients have small amount ofsubconjunctival hemorrhage,and1patient has an emergence of a transient high intraocular pressure after the injection,and1patient has increasing vitreous floaters case after injection.After1-6months’ follow-up, there is no glaucoma, a serious complication of intraocular infection, cataracts retinal detachment and any systemic adverse reactions associated with the drug.(4) Throughout the study,5patients receives2times injection treatment and7patients receives3times injections treatment.In the all study,there is the average of1.5±0.79times injection per person. In simple injection treatment group, there is the average of1.47±0.75times injection per person. In comprehensive treatment group, there is the average of1.53±0.82times injection per person.Conclusion:Traditional Chinese medicine combined with intravitreous injection with Ranibizumab(IVR) is an efficacious treatment for macular edema(ME).The combined therapy could improve visual acuity and reduce reninal thickness more effectively. There are no serious ocular and systemic complications and side effects occurredduring our study.However,some patients need repeated IVR to retain the efficacy.