| Objective: To observe the efficacy of retinal photocoagulation combining with Lucentis or Conbercept,and single retinal laser photocoagulation on ischemic-type macular edema due to branch retinal vein occlusion(BRVO-ME).Methods: The paper was a retrospective cohort study,in which 75 eyes in 75 patients with ischemic BRVO-ME were collected in Qianxinan People's Hospital from January2014 to June 2016.75 eyes of 75 patients were diagnosed as ischemic BRVO-ME by way of fundus examination,optical coherence tomography(OCT)and fundus fluorescein angiography(FFA).According their desire,these patients were divided into Group A,B,and C,in which,group A included 30 cases(30 eyes)for Lucentis combining with retinal photocoagulation.Another 24 cases(24 eyes)for Conbercept combining with retinal photocoagulation were served as Group B.And the rest,21 cases(21 eyes)were put into single retinal photocoagulation Group C.One week after intravitreal injection,Group A and B were treated with retinal photocoagulation;Group C was directly treated with retinal photocoagulation.After the first treatment,the best corrected visual acuity(BCVA)was examined,central macular thickness(CMT)was measured using OCT through the monthly follow-up visits,FFA was reexamined every three months,and repeated treatment was performed according to the BCVA,OCT and FFA.Changes of BCVA,CMT,fundus and complications were recorded after1,2,3,and 6 months,and the efficacy and safety were compared among the three groups.Results: 1.BCVA(log MAR):In the final follow-up,the mean value of BCVA(log MAR)in Group A,B and C was significantly lower,and such difference was statistically significant(P<0.05).The effective rate of Group A,B and C were 93.4%,95.8%,52.4%,and there was no statistical significance(P>0.05)between Group A and B.There was a statistical significance between Group A and Group C,or between Group B and Group C(P<0.05).2.CMT(?m): In the final follow-up,the mean value of CMT in Group A,B and C were significantly lower,and such difference was statistically significant(P<0.05),but there was no statistical significance between Group A and Group B(P>0.05);the mean value of CMT in Group A,B was lower than Group C,and such difference was statistically significant(P<0.05).3.In the final follow-up,The results of FFA show that the effective rate of Group A,B and C were 93.3%,95.8%,71.4%,and there was no statistical significance between Group A and B(P>0.05);the efficacy of Group A,B were better than Group C and such difference was statistically significant(P<0.05).4.Comparison of injection times: During the average six months of follow-up,the difference of injection times between Lucentis or Conbercept combining with retinal photocoagulation had no statistical significance(P>0.05).5.Complications: During the follow-up,6 cases in Group A were found having corneal epithelial peeling,and all occurred in the first day after intravitreal injection,and the corneal epithelium completely repaired within three days.Intraocular inflammation,persistent ocular hypertension,iatrogenic cataract,retinal detachment didn't occur in Group A,B and C.Conclusion: 1.Either intravitreal injection of Lucentis or Conbercept combining with retinal photocoagulation,or single retinal photocoagulation,would effectively improve the visual acuity and reduce their CMT,without serious adverse reactions.2.The efficacy of anti-VEGF combining with retinal photocoagulation was better than single retinal photocoagulation.3.The efficacy of Lucentis or Conbercept combining with retinal photocoagulation was equivalent in the short term,both of them cannot be sustained for long periods of time.4.Both Lucentis and Conbercept have satisfied effects on eliminating swelling of macular edema,which provide early retinal photocoagulation therapy and obviously reduce the retinal photoreceptors irreversible damage caused by the long-term macular edema. |
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